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

2021 ◽  
Vol 8 (12) ◽  
pp. 183
Author(s):  
Charles Guenancia ◽  
Nefissa Hammache ◽  
Clémence Docq ◽  
Karim Benali ◽  
Darren Hooks ◽  
...  

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.

EP Europace ◽  
2018 ◽  
Vol 20 (suppl_1) ◽  
pp. i127-i127
Author(s):  
V Galizia Brito ◽  
N March Vecchio ◽  
J Jarma ◽  
L Tomas ◽  
I Mondragon ◽  
...  

2016 ◽  
Vol 157 (22) ◽  
pp. 849-854 ◽  
Author(s):  
Zsófia Nagy ◽  
Zsuzsanna Kis ◽  
Zoltán Som ◽  
Csaba Földesi ◽  
Attila Kardos

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.


Heart Rhythm ◽  
2016 ◽  
Vol 13 (4) ◽  
pp. 836-844 ◽  
Author(s):  
Martin Schmidt ◽  
Uwe Dorwarth ◽  
Dietrich Andresen ◽  
Johannes Brachmann ◽  
Karlheinz Kuck ◽  
...  

2021 ◽  
Author(s):  
Xiaoxv Yang ◽  
Hui-Yuan Zhou ◽  
Ya-Le Lu

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.


Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S125-S126
Author(s):  
Takashi Yamasaki ◽  
Tetsuhisa Hattori Keisuke Ohta ◽  
Nobuyuki Miyai, Reo Nakamura ◽  
Takayoshi Sawanishi Noriyuki Kinosita ◽  
Ken Kakita

Author(s):  
Shinwan Kany ◽  
Johannes Brachmann ◽  
Thorsten Lewalter ◽  
Ibrahim Akin ◽  
Horst Sievert ◽  
...  

Abstract Background Non-paroxysmal (NPAF) forms of atrial fibrillation (AF) have been reported to be associated with an increased risk for systemic embolism or death. Methods Comparison of procedural details and long-term outcomes in patients (pts) with paroxysmal AF (PAF) against controls with NPAF in the prospective, multicentre observational registry of patients undergoing LAAC (LAARGE). Results A total of 638 pts (PAF 274 pts, NPAF 364 pts) were enrolled. In both groups, a history of PVI was rare (4.0% vs 1.6%, p = 0.066). The total CHA2DS2-VASc score was lower in the PAF group (4.4 ± 1.5 vs 4.6 ± 1.5, p = 0.033), while HAS-BLED score (3.8 ± 1.1 vs 3.9 ± 1.1, p = 0.40) was comparable. The rate of successful implantation was equally high (97.4% vs 97.8%, p = 0.77). In the three-month echo follow-up, LA thrombi (2.1% vs 7.3%, p = 0.12) and peridevice leak > 5 mm (0.0% vs 7.1%, p = 0.53) were numerically higher in the NPAF group. Overall, in-hospital complications occurred in 15.0% of the PAF cohort and 10.7% of the NPAF cohort (p = 0.12). In the one-year follow-up, unadjusted mortality (8.4% vs 14.0%, p = 0.039) and combined outcome of death, stroke and systemic embolism (8.8% vs 15.1%, p = 0.022) were significantly higher in the NPAF cohort. After adjusting for CHA2DS2-VASc and previous bleeding, NPAF was associated with increased death/stroke/systemic embolism (HR 1.67, 95% CI 1.02–2.72, p = 0.041). Conclusion Atrial fibrillation type did not impair periprocedural safety or in-hospital MACE patients undergoing LAAC. However, after one year, NPAF was associated with higher mortality. Graphic abstract


2020 ◽  
Vol 35 (12) ◽  
pp. 1709-1716
Author(s):  
Tomomasa Takamiya ◽  
Junichi Nitta ◽  
Osamu Inaba ◽  
Akira Sato ◽  
Yukihiro Inamura ◽  
...  

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