Key result
Radiofrequency ablation significantly increased the risk of late recurrence of atrial arrhythmia compared to cryoballoon ablation (HR 2.93) in patients with paroxysmal atrial fibrillation.
Why the study?
Early recurrence after PVI for AF is expected to resolve within the blanking period, but the relationship between early and late recurrence across different ablation devices required comparison.
Does radiofrequency ablation compared to cryoballoon ablation reduce early and late recurrence of atrial fibrillation in patients with drug-refractory paroxysmal AF?
Cohort (n=294)
No
Does radiofrequency ablation compared to cryoballoon ablation reduce early and late recurrence of atrial fibrillation in patients with drug-refractory paroxysmal AF?
Hazard Ratio: 2.93 (95% CI 1.64–5.23)
p-value: p=<0.01
In patients with paroxysmal atrial fibrillation, radiofrequency ablation is associated with a higher risk of late recurrence compared to cryoballoon ablation.
RF ablation was associated with higher late recurrence than cryoballoon in paroxysmal AF; leaves open whether randomized trials would confirm a true difference.
Objective Early recurrence (ER) after pulmonary vein isolation (PVI) for atrial fibrillation (AF) is expected to resolve within the recommended 3-month blanking period, irrespective of the ablation device used. To compare the occurrence and relationship of AF within the blanking period and subsequent late recurrence (LR) with radiofrequency (RF) and cryoballoon (CB) ablation. Methods A retrospective analysis of 294 patients (mean age=62±9, 70.0% male) undergoing PVI for drug-refractory paroxysmal AF was done. After categorizing the patients into the RF group (n=152) and the CB group (n=142), a group-wise comparison was done to investigate the impact of ER on LR throughout a 2-year follow-up. Results The groups were similar regarding the occurrence of ER (RF=22.4%, CB=24.6%, p=0.62), while LR was significantly higher in the RF group (p=0.003). ER was associated with LR in the RF group (p<0.01) but not in the CB group (p=0.08), while a significant independent association with an increased LR risk was observed [hazard ratio (HR) 6.12; 95% confidence interval (CI) 3.56-10.51, p<0.01]. RF ablation also significantly increased the risk of LR (HR=2.93; 95% CI=1.64-5.23, p<0.01). Conclusion A recurrence of atrial arrhythmia is more frequent with RF-PVI than with CB-PVI for patients with paroxysmal AF. ER and RF-ablation are strong predictors for LR after the 3-month blanking period.
No takes yet. Share an insight, caveat, or question.
Terata et al. (2022) conducted a cohort in Symptomatic drug-refractory paroxysmal atrial fibrillation (n=294). Radiofrequency (RF) ablation vs. Cryoballoon (CB) ablation was evaluated on Late recurrence of atrial arrhythmia (HR 2.93, 95% CI 1.64-5.23, p=<0.01). Radiofrequency ablation significantly increased the risk of late recurrence of atrial arrhythmia compared to cryoballoon ablation (HR 2.93) in patients with paroxysmal atrial fibrillation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: