Sven Knecht1, Christian Sticherling1, Stefanie von Felten2, David Conen3, Beat Schaer1, Peter Ammann4, David Altmann4, Stefan Osswald1, Michael Kühne5. 1. Department of Cardiology, University Hospital Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland. 2. Clinical Trial Unit, University Hospital Basel, Switzerland. 3. Department of Internal Medicine, University Hospital Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland. 4. Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland. 5. Department of Cardiology, University Hospital Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland. Electronic address: Michael.Kuehne@usb.ch.
Abstract
BACKGROUND: Although radiofrequency (RF) and cryoballoon (CB) based technologies for pulmonary vein isolation (PVI) have both individually been demonstrated to be effective and safe for the treatment of paroxysmal AF, head-to-head comparisons are lacking. The purpose of this study was to compare the outcome of cryoballoon versus radiofrequency ablation in patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation. METHODS: Out of a prospective registry of 327 patients undergoing PVI, 208 patients (age 58±11 years, ejection fraction 59±6%, left atrial size 39±6 mm) with paroxysmal AF were identified. The presented dataset was obtained by 1:1 propensity score matching and contained 142 patients undergoing CB-PVI or RF-PVI in conjunction with a 3D mapping system, respectively. We compared single procedure efficacy of the two methods using a Cox proportional hazards model. RESULTS: After a mean follow-up of 28 months and a single procedure, AF recurred in 37 of 71 (52%) in the CB-PVI group and in 31 of 71 patients (44%) in the RF-PVI group (HR [95% CI]=1.19 [0.74, 1.92], p=0.48). Recurrence of AF for PVI using solely the CB was observed in 23 of 51 (45%) patients and in 23 of 51 (45%) patients in the corresponding RF-PVI group (HR [95% CI]=0.93 [0.52, 1.66], p=0.81). Complication rate was not different between the groups. CONCLUSION: A propensity score matched comparison between CB-PVI and RF-PVI using a 3D-mapping system for AF ablation showed similar long-term success rates.
BACKGROUND: Although radiofrequency (RF) and cryoballoon (CB) based technologies for pulmonary vein isolation (PVI) have both individually been demonstrated to be effective and safe for the treatment of paroxysmal AF, head-to-head comparisons are lacking. The purpose of this study was to compare the outcome of cryoballoon versus radiofrequency ablation in patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation. METHODS: Out of a prospective registry of 327 patients undergoing PVI, 208 patients (age 58±11 years, ejection fraction 59±6%, left atrial size 39±6 mm) with paroxysmal AF were identified. The presented dataset was obtained by 1:1 propensity score matching and contained 142 patients undergoing CB-PVI or RF-PVI in conjunction with a 3D mapping system, respectively. We compared single procedure efficacy of the two methods using a Cox proportional hazards model. RESULTS: After a mean follow-up of 28 months and a single procedure, AF recurred in 37 of 71 (52%) in the CB-PVI group and in 31 of 71 patients (44%) in the RF-PVI group (HR [95% CI]=1.19 [0.74, 1.92], p=0.48). Recurrence of AF for PVI using solely the CB was observed in 23 of 51 (45%) patients and in 23 of 51 (45%) patients in the corresponding RF-PVI group (HR [95% CI]=0.93 [0.52, 1.66], p=0.81). Complication rate was not different between the groups. CONCLUSION: A propensity score matched comparison between CB-PVI and RF-PVI using a 3D-mapping system for AF ablation showed similar long-term success rates.
Authors: Jan W Schrickel; Markus Linhart; Dietmar Bänsch; Daniel Thomas; Georg Nickenig Journal: Clin Res Cardiol Date: 2015-10-29 Impact factor: 5.460
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