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August 5, 2018The Korean Journal of Thoracic and Cardiovascular SurgeryOpen Access

Comparison of Radiofrequency Ablation and Cryoablation for the Recovery of Atrial Contractility and Survival

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Key result

Cryoablation significantly increased the likelihood of atrial contractility recovery at 1 year compared to radiofrequency ablation (OR 2.540) in patients with atrial fibrillation.

Why the study?

Does surgical cryoablation improve atrial contractility and survival compared to radiofrequency ablation in patients with atrial fibrillation?

Population

239 patients with atrial fibrillation who underwent surgical ablation at a single institution

Comparison

Surgical cryoablation (n=99) vs Surgical radiofrequency ablation (n=140)

Design

Cohort

Follow-up

median 36 months

Authors

KKKang Min KimCross-Cutting CardiologySCSuryeun ChungSamsung Medical CenterSKSang Yoon KimSeoul National University

Discussion

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Overview

May support preferring cryoablation for atrial recovery in surgical AF; leaves open need for randomized confirmation.

Study Design

Type

Cohort (n=239)

Multicenter

No

Structured PICO

Does surgical cryoablation improve atrial contractility and survival compared to radiofrequency ablation in patients with atrial fibrillation?

P
Population
239 patients with atrial fibrillation undergoing surgical ablation, followed for a median of 36 months to compare radiofrequency and cryoablation.
I
Intervention
Surgical cryoablation (n=99)
C
Comparator
Surgical radiofrequency ablation (n=140)
O
Outcome
Clinical outcomes, restoration of sinus rhythm or atrial contractility, overall survival, and major cardiovascular and cerebrovascular event (MACCE)-free survivalcomposite

Main Result

Odds Ratio: 2.54 (95% CI 1.063–6.071)

Absolute Event Rate: 48.8% vs 32.2%

p-value: p=0.036

Surgical cryoablation for atrial fibrillation is associated with better recovery of atrial contractility and left ventricular function compared to radiofrequency ablation, though long-term survival and MACCE rates are similar.

Limitations

  • Retrospective single-center study design
  • Energy sources and equipment used in surgical ablation changed over time
  • Atrial contractility was only assessed by the presence of the A-wave in trans-mitral flow
  • Did not include functional class assessments
  • Loss to follow-up and variations in the echocardiographic follow-up period

Cite This Study

Kim et al. (2018) conducted a cohort in Atrial fibrillation (n=239). Cryoablation vs. Radiofrequency ablation was evaluated on Recovery of atrial contractility at 1 year (OR 2.540, 95% CI 1.063-6.071, p=0.036). Cryoablation significantly increased the likelihood of atrial contractility recovery at 1 year compared to radiofrequency ablation (OR 2.540) in patients with atrial fibrillation.

synapsesocial.com/papers/6a791ed53057cf3c2e021eb8https://doi.org/10.5090/kjtcs.2018.51.4.266
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Impact of ablation duration on rhythm outcome after concomitant maze procedure using cryoablation in patients with persistent atrial fibrillation2017 · 7 citations
  2. 2Cryoablation for surgical treatment of chronic atrial fibrillation combined with mitral valve surgery: a clinical observation2008 · 29 citations
  3. 3Surgical Treatment of Concomitant Atrial Fibrillation: Focus onto Atrial Contractility2015 · 12 citations