German ablation registry: Cryoballoon vs radiofrequency ablation in paroxysmal atrial fibrillation—One-year outcome data

Introduction: Contact force sensing radiofrequency ablation and the new generation cryoballoon ablation are prevalent techniques for the treatment of paroxysmal atrial fibrillation. Aim: The authors aimed to compare the procedural and 1-year outcome of patients after radiofrequency and cryoballoon ablation. Method: 96 patients with paroxysmal atrial fibrillation (radiofrequency ablation: 58, cryoballoon: 38 patients; 65 men and 31 women aged 28–70 years) were enrolled. At postprocedural 1, 3, 6 and 12 months ECG, Holter monitoring and telephone interviews were performed. Results: Procedure and fluorosocopy time were: radiofrequency ablation, 118.5 ± 15 min and 15.8 ± 6 min; cryoballoon, 73.5 ± 16 min (p<0.05) and 13.8 ± 4.,1 min (p = 0.09), respectively. One year later freedom from atrial fibrillation was achieved in 76.5% of patients who underwent radiofrequency ablation and in 81% of patients treated with cryoballoon. Temporary phrenic nerve palsy occurred in two patients and pericardial tamponade developed in one patient. Conclusions: In this single center study freedom from paroxysmal atrial fibrillation was similar in the two groups with significant shorter procedure time in the cryoballoon group. Orv. Hetil., 2016, 157(22), 849–854.

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Comparison of Radiofrequency Ablation and Cryoablation for Paroxysmal Atrial Fibrillation：A Meta-Analysis of Randomized Controlled Trials. (Preprint)

10.2196/preprints.29886 ◽

2021 ◽

Author(s):

Xiaoxv Yang ◽

Hui-Yuan Zhou ◽

Ya-Le Lu

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Randomized Controlled Trials ◽

Paroxysmal Atrial Fibrillation ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Randomized Controlled ◽

One Year ◽

Better Than

BACKGROUND Some studies have compared the effects of radiofrequency current energy and cryoballoon in patients with paroxysmal atrial fibrillation. The results on the rate of atrial fibrillation and the incidence of complications one year after ablation were inconsistent with these studies. OBJECTIVE The purpose of this study was to evaluate whether the efficacy and safety of cryoballoon (CB) are better than that of radiofrequency ablation(RF) for pulmonary vein isolation in the treatment of paroxysmal atrial fibrillation(PAF). METHODS The Pubmed and Cochrane Library databases were searched for randomized controlled trials(RCTs) since inception through August 2020. The efficacy outcome was success rate one year after ablation. Rate of complications safety outcome. Included studies were RCTs in adults with PAF in which CB therapy was compared to RF therapy. Two investigators extracted data from the selected studies and assessed the risk of bias. RESULTS A total of 6 RCTs with 1681 individuals were included in the analysis. Pooled analyses indicated that CB ablation had a lower rate of the free-from atrial fibrillation(AF) one year after catheter ablation than RF therapy,but not statistically significant (OR: 0.88; 95% CI: 0.57 to 1.36;p=0.57). There was a higher rate of complications in the CB group,but not significant (OR: 1.27;95% CI: 0.73 to 2.22;p=0.39). CONCLUSIONS This meta-analysis shows that CB is not better than RF for patients with paroxysmal atrial fibrillation, and the incidence of complications is not lower than RF.

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Efficacy and Safety of Second and Third-Generation Laser Balloon for Paroxysmal Atrial Fibrillation Ablation Compared to Radiofrequency Ablation: A Matched-Cohort

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd8120183 ◽

2021 ◽

Vol 8 (12) ◽

pp. 183

Author(s):

Charles Guenancia ◽

Nefissa Hammache ◽

Clémence Docq ◽

Karim Benali ◽

Darren Hooks ◽

...

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Paroxysmal Atrial Fibrillation ◽

Clinical Success ◽

Third Generation ◽

Laser Applications ◽

Major Increase ◽

One Year ◽

The One ◽

Laser Balloon

Laser balloon (LB) has emerged as an interesting strategy for pulmonary vein isolation in paroxysmal atrial fibrillation (AF). A third-generation LB has recently been developed, allowing a continuous ablation set. We aimed to compare the results from our center’s experience with second and third-generation LBs to a cohort of matched patients who had undergone radiofrequency ablation (RFA) with contact-force catheters. This retrospective monocenter case-control study included our first 50 LB paroxysmal AF ablations (26 second and 24 third-generation LB) and 50 RFA controls, matched on age, sex and left atrial dilation. The two groups had similar baseline parameters. LB procedures were significantly shorter than RFA (129 (110–160) vs. 160 (119–198) min, p = 0.007). During AF ablation, two major complications occurred in each group. At the one-year follow-up, AF recurrence was diagnosed in 7 (14%) of the LB group vs. 14 (28%) of the RFA group (p = 0.14). Moreover, we observed that third-generation LB procedures were associated with shorter laser applications (22 (19–29) vs. 69 (55–76) min, p < 0.001) and procedural durations (111 (100–128) vs. 151.5 (128.5–167) min, p < 0.001) compared to second-generation LB procedures. In the context of the major increase in the number of AF ablations, LB demonstrated consistent results in terms of clinical success, complications and also reduced procedure durations compared to RFA.

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