Key result
Cryoballoon ablation caused less inflammation than radiofrequency ablation, yielding similar early recurrence rates (21.8% vs 28.9%, p=0.26) but different predictive values for late recurrence.
Why the study?
Early recurrence after catheter ablation for AF is common, but its mechanism and implication in long-term outcome have not been fully elucidated.
Does cryoballoon ablation compared to radiofrequency ablation affect post-ablation inflammation and early recurrence in patients with paroxysmal atrial fibrillation?
Observational (n=154)
No
Does cryoballoon ablation compared to radiofrequency ablation affect post-ablation inflammation and early recurrence in patients with paroxysmal atrial fibrillation?
Post-ablation inflammation is greater after radiofrequency ablation than cryoballoon ablation, and excessive inflammation is associated with acute early recurrence after RFA, whereas lower inflammation predicts acute early recurrence after CBA.
Answers are grounded in this paper and cite their sources.
Less inflammation after CBA than RFA was not linked to early recurrence differences; leaves open differential prediction of late recurrence and needs randomized confirmation.
BACKGROUND: Early recurrence (ER) after catheter ablation for atrial fibrillation (AF) has been considered as a common phenomenon but its mechanism and implication in long-term outcome has not been fully elucidated. We aimed to clarify the relation between post-ablation inflammation and ER after cryoballoon ablation (CBA) or radio-frequency ablation (RFA) and evaluate the clinical significance of ER. METHODS: A total of 154 patients with paroxysmal AF undergoing ablation were consecutively recruited, including 90 patients undergoing RFA (RF group) and 64 patients undergoing CBA (CB group). Myocardial injury and inflammation biomarkers were analyzed before and 6 h, 24 h and 48 h after ablation. Acute early recurrence (AER), non-acute early recurrence (NAER) and late recurrence (LR) was defined as recurrence of atrial tachyarrhythmia during 0-3, 4-90 days and beyond a 90-day blanking period after ablation. RESULTS: Cardiac troponin I was significantly higher in CB group while C reactive protein (CRP) and Ratio Neutrophil/Lymphocyte were more elevated in RF group. Higher CRP level after RFA was significantly associated with AER in RF group and lower CRP level after CBA was predictive of AER in CB group. In addition, average cryoablation duration was positively correlated with CRP level after CB group. Cox regression revealed that NAER and left atrial diameter were associated with LR in RF group, while AER and NAER were predictive of LR after CBA. CONCLUSIONS: Post-ablation inflammation was greater in RFA than in CBA. Excessive inflammatory response may be an important factor of AER after RFA. AER after CBA was related with lower inflammation and predictive of LR. Further investigations are still warranted to address on these findings.
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Bao et al. (2022) conducted an observational in Paroxysmal atrial fibrillation (n=154). Cryoballoon ablation vs. Radiofrequency ablation was evaluated on Early recurrence (ER) during a 90-day blanking period (p=0.26). Cryoballoon ablation caused less inflammation than radiofrequency ablation, yielding similar early recurrence rates (21.8% vs 28.9%, p=0.26) but different predictive values for late recurrence.
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