February 1, 2024EP EuropaceOpen Access

Pre-emptive catheter ablation after a CryoMaze procedure reduced the first recurrence of AF/AT compared to surgery alone (41.1% vs. 67.4%; HR 0.38; 95% CI 0.26-0.57; P<0.001).

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Non-paroxysmal atrial fibrillation (n=229). Intervention: Radiofrequency catheter ablation vs. No further treatment (surgical ablation alone). Primary outcome: First recurrence of AF/AT without class I or III antiarrhythmic drugs (HR 0.38, 95% CI 0.26-0.57, p=<0.001).

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Why the study?

Data on hybrid AF treatment are lacking in patients with structural heart disease undergoing concomitant CryoMaze procedures.

Does sequential hybrid ablation (radiofrequency catheter ablation after CryoMaze) reduce AF/AT recurrence and improve clinical outcomes compared to surgical CryoMaze alone in patients with non-paroxysmal AF undergoing cardiac surgery?

Population

113 Hybrid and 116 Surgery Group patients with non-paroxysmal AF undergoing CABG and/or valve surgery with CryoMaze

Comparison

Pre-emptive radiofrequency catheter ablation vs no further treatment after CryoMaze

Design

Multicentre randomized controlled trial

Follow-up

Median 715 (IQR: 528-1072) days

Key result

Pre-emptive catheter ablation after a CryoMaze procedure reduced the first recurrence of AF/AT compared to surgery alone (41.1% vs. 67.4%; HR 0.38; 95% CI 0.26-0.57; P<0.001).

Authors

ABAlan Bulava DWDan Wichterle AMAleš Mokráček

Discussion

Member takes

Overview

Supports sequential hybrid ablation post-CryoMaze in non-paroxysmal AF surgery patients; extends RCT evidence for better rhythm and clinical outcomes in structural heart disease.

Study Design

Type

RCT (n=229)

Randomization

randomly assigned

Multicenter

Yes

Structured PICO

Population

229 patients with non-paroxysmal AF undergoing CABG and/or valve surgery with a concomitant CryoMaze procedure, followed for a median of 715 days.

Intervention

Radiofrequency catheter ablation performed pre-emptively after the CryoMaze procedure (Hybrid Group).

Comparator

No further treatment after the CryoMaze procedure (Surgery Group).

Outcome

First recurrence of AF/AT without class I or III antiarrhythmic drugs as assessed by implantable cardiac monitors (primary efficacy endpoint), and a composite of hospitalization for arrhythmia recurrence, worsening of heart failure, cardioembolic event, or major bleeding (primary clinical endpoint).composite

Main Result

Hazard Ratio: 0.38 (95% CI 0.26–0.57)

Absolute Event Rate: 41.1% vs 67.4%

p-value: p=<0.001

Pre-emptive radiofrequency catheter ablation after surgical CryoMaze significantly reduces AF/AT recurrence and improves clinical outcomes in patients with non-paroxysmal AF undergoing cardiac surgery.

Cite This Study

Bulava et al. (2024) conducted an RCT in Non-paroxysmal atrial fibrillation (n=229). Radiofrequency catheter ablation vs. No further treatment (surgical ablation alone) was evaluated on First recurrence of AF/AT without class I or III antiarrhythmic drugs (HR 0.38, 95% CI 0.26-0.57, p=<0.001). Pre-emptive catheter ablation after a CryoMaze procedure reduced the first recurrence of AF/AT compared to surgery alone (41.1% vs. 67.4%; HR 0.38; 95% CI 0.26-0.57; P<0.001).

synapsesocial.com/papers/6a902926f5c79ce9992d9ff1 https://doi.org/10.1093/europace/euae040

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February 1, 2024EP EuropaceOpen Access

Pre-emptive catheter ablation after a CryoMaze procedure reduced the first recurrence of AF/AT compared to surgery alone (41.1% vs. 67.4%; HR 0.38; 95% CI 0.26-0.57; P<0.001).

View Full Paper

Ask AI

Bookmark

Why the study?

Data on hybrid AF treatment are lacking in patients with structural heart disease undergoing concomitant CryoMaze procedures.

Population

113 Hybrid and 116 Surgery Group patients with non-paroxysmal AF undergoing CABG and/or valve surgery with CryoMaze

Comparison

Pre-emptive radiofrequency catheter ablation vs no further treatment after CryoMaze

Design

Multicentre randomized controlled trial

Follow-up

Median 715 (IQR: 528-1072) days

Key result

Pre-emptive catheter ablation after a CryoMaze procedure reduced the first recurrence of AF/AT compared to surgery alone (41.1% vs. 67.4%; HR 0.38; 95% CI 0.26-0.57; P<0.001).

Authors

ABAlan Bulava DWDan Wichterle AMAleš Mokráček

Discussion

Member takes

Overview

Supports sequential hybrid ablation post-CryoMaze in non-paroxysmal AF surgery patients; extends RCT evidence for better rhythm and clinical outcomes in structural heart disease.

Study Design

Type

RCT (n=229)

Randomization

randomly assigned

Multicenter

Yes

Structured PICO

Population

229 patients with non-paroxysmal AF undergoing CABG and/or valve surgery with a concomitant CryoMaze procedure, followed for a median of 715 days.

Intervention

Radiofrequency catheter ablation performed pre-emptively after the CryoMaze procedure (Hybrid Group).

Comparator

No further treatment after the CryoMaze procedure (Surgery Group).

Outcome

Main Result

Hazard Ratio: 0.38 (95% CI 0.26–0.57)

Absolute Event Rate: 41.1% vs 67.4%

p-value: p=<0.001

Cite This Study

synapsesocial.com/papers/6a902926f5c79ce9992d9ff1 https://doi.org/10.1093/europace/euae040

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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