Catheter ablation using the second-generation cryoballoon resulted in greater freedom from atrial arrhythmias at 12 months compared to radiofrequency (76.6% vs 60.4%; P<0.001).
Cohort (n=1,196)
Yes
Does catheter ablation using the second-generation cryoballoon improve freedom from atrial arrhythmias at 12 months compared to open-irrigated radiofrequency in patients with atrial fibrillation?
Second-generation cryoballoon ablation for atrial fibrillation is associated with shorter procedure times and greater 12-month freedom from atrial arrhythmias compared to open-irrigated radiofrequency, though with a higher risk of phrenic nerve palsy.
Absolute Event Rate: 76.6% vs 60.4%
p-value: p=<0.001
Second‐Generation Cryoballoon versus RF Introduction There are limited comparative data on catheter ablation of atrial fibrillation (CAAF) using the second‐generation cryoballoon (CB‐2) versus point‐by‐point radiofrequency (RF). This study examines the acute/long‐term CAAF outcomes using these 2 strategies. Methods and Results In this multicenter, retrospective, nonrandomized analysis, procedural and clinical outcomes of 1,196 patients (76% with paroxysmal AF) undergoing CAAF using CB‐2 (n = 773) and open‐irrigated, non‐force sensing RF (n = 423) were evaluated. Pulmonary vein isolation was achieved in 98% with CB‐2 and 99% with RF (P = 0.168). CB‐2 was associated with shorter ablation time (40 ± 14 min vs. 66 ± 26 min; P < 0.001) and procedure time (145 ± 49 minutes vs. 188 ± 42 minutes; P < 0.001), but greater fluoroscopic utilization (29 ± 13 minutes vs. 23 ± 14 minutes; P < 0.001). While transient (7.6% vs. 0%; P < 0.001) and persistent (1.2% vs. 0%; P = 0.026) phrenic nerve palsy occurred exclusively with CB‐2, other adverse event rates were similar between CB‐2 (1.6%) and RF (2.6%); P = 0.207. However, freedom from AF/atrial flutter/tachycardia at 12 months following a single procedure without antiarrhythmic therapy was greater with CB‐2 (76.6%) versus RF (60.4%); P < 0.001. While this difference was evident in patients with paroxysmal AF (P < 0.001), it did not reach significance in those with persistent AF (P = 0.089). Additionally, CB‐2 was associated with reduced long‐term need for antiarrhythmic therapy (16.7% vs. 22.0%; P = 0.024) and repeat ablations (14.6% vs. 24.1%; P < 0.001). Conclusion In this multicenter, retrospective, nonrandomized study, CAAF using CB‐2 coupled with RF as occasionally required was associated with greater freedom from atrial arrhythmias at 12 months following a single procedure without antiarrhythmic therapy when compared to open‐irrigated, non‐force sensing RF, alone.
Aryana et al. (Mon,) conducted a cohort in Atrial fibrillation (n=1,196). Second-generation cryoballoon (CB-2) vs. Open-irrigated, non-force sensing radiofrequency (RF) was evaluated on Freedom from AF/atrial flutter/tachycardia at 12 months following a single procedure without antiarrhythmic therapy (p=<0.001). Catheter ablation using the second-generation cryoballoon resulted in greater freedom from atrial arrhythmias at 12 months compared to radiofrequency (76.6% vs 60.4%; P<0.001).