Key result
Cryoballoon ablation or radiofrequency catheter ablation combined with LAAO showed similar complete occlusion rates at 3 months compared to LAAO alone (64.8% vs 60.7% vs 62.4%, p=0.794).
Why the study?
The study was designed to compare peri-procedural safety, occlusion rates, peri-device leak, and device-related thrombosis among LAAO alone, CBA combined with LAAO, and RFCA combined with LAAO, and to explore risk factors for leak and incomplete occlusion.
Does combining cryoballoon or radiofrequency ablation with LAAO affect peri-procedural safety and 3-month occlusion efficacy compared to LAAO alone in patients with non-valvular AF?
Cohort (n=382)
Does combining cryoballoon or radiofrequency ablation with LAAO affect peri-procedural safety and 3-month occlusion efficacy compared to LAAO alone in patients with non-valvular AF?
Answers are grounded in this paper and cite their sources.
Combining cryoballoon or radiofrequency ablation with LAAO yields similar safety and 3-month occlusion efficacy compared to LAAO alone in patients with non-valvular AF.
Background Left atrial appendage occlusion (LAAO) serves as an alternative to oral anticoagulation (OAC) for atrial fibrillation (AF) patients at high risk of bleeding. The aim of this study was to compare the peri-procedural safety, complete or incomplete occlusion, the incidence of the peri-device leak (PDL), and device-related thrombosis (DRT) among LAAO, cryoballoon ablation (CBA) combined with LAAO, and radiofrequency catheter ablation (RFCA) combined with LAAO and to explore the risk factors of PDL and incomplete occlusion. Methods 382 patients with non-valvular AF who underwent either LAAO alone (n = 117), CBA combined with LAAO (n = 125), or RFCA combined with LAAO (n = 140) were included in the retrospective study. The study assessed peri-procedural complications and imaging results (3 months post-procedure). Multivariable logistic regression was employed to identify risk factors for incomplete occlusion and PDL. Results Peri-procedural complication rates were low among all groups, with 2.9% in the RFCA combined with the LAAO group. In contrast, the LAAO alone and CBA combined with LAAO groups reported no major complications (p = 0.347). At the 3-month follow-up, the incidence of DRT was 1.7% in the LAAO group, 2.4% in the CBA combined with the LAAO group, and 2.1% in the RFCA combined with the LAAO group (p = 0.930). Complete occlusion rates were comparable among the groups: 64.8% for CBA combined with LAAO, 62.4% for LAAO alone, and 60.7% for RFCA combined with LAAO (p = 0.794). PDL occurred in 33.3% of LAAO-alone patients, 34.4% of CBA combined with LAAO patients, and 38.6% of RFCA combined with LAAO patients (p = 0.644). Multivariable analysis identified persistent AF and serum creatinine (SCr) as independent predictors of PDL and incomplete occlusion. Conclusion Peri-procedural complications, complete occlusion, PDL, and DRT rates were similar across the three treatment strategies. Persistent AF and SCr were significant risk factors for incomplete occlusion and PDL. These findings highlight the importance of individualized treatment strategies based on patient-specific risk factors for optimizing outcomes.
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Jiang et al. (2025) conducted a cohort in non-valvular atrial fibrillation (n=382). Cryoballoon ablation or radiofrequency catheter ablation combined with LAAO vs. LAAO alone was evaluated on Complete occlusion at 3 months (p=0.794). Cryoballoon ablation or radiofrequency catheter ablation combined with LAAO showed similar complete occlusion rates at 3 months compared to LAAO alone (64.8% vs 60.7% vs 62.4%, p=0.794).
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