Radiofrequency or cryoballoon ablation for index pulmonary vein isolation: What is the impact on long-term clinical outcomes after repeat ablation?
J Cardiovasc Electrophysiol
; 31(5): 1068-1074, 2020 05.
Article
en En
| MEDLINE
| ID: mdl-32128924
ABSTRACT
AIMS:
The current study sought to assess the impact of the utilized energy source during index ablation on long-term clinical outcomes after repeat ablation of atrial fibrillation (AF). Index ablation procedures were either performed using radiofrequency current (RFC) (RFC group) or cryoballoon (CB) ablation (CB group). Repeat ablation was performed by the use of RFC.METHODS:
A total of 195 patients (138 RFC group; 57 CB group) with paroxysmal AF were included. All patients had a recurrence of AF following the index ablation procedure. Freedom from AF was estimated with the Kaplan-Meier method.RESULTS:
After a 3 years follow-up, the estimated arrhythmia-free survival did not differ between the two groups (RFC group 48% vs CB group 47%, P = .78). During index ablation, procedure times were significantly shorter in the CB group (95 [80, 140] vs 140 [115, 164] minutes, P ≤ .001), whereas fluoroscopy times (16 [11; 22] vs 19 [14; 25] minutes, P = .003), the dose area product (1862 [1203; 2922] vs 3148 [1756; 5888] cGycm2 , P ≤ .001) and the amount of contrast dye (92 ± 32 vs 123 ± 33 mL, P ≤ .001) were significantly lower in the RFC group. During repeat ablation, procedure times were significantly shorter in patients being initially treated with RFC (115 [85; 145] vs 125 [105; 150] minutes, P = .007). There was a trend towards a higher pulmonary vein reconnection rate in the RFC group without meeting statistical significance (P = .074).CONCLUSIONS:
In patients with repeat ablation of AF, index RFC or CB ablation are equally effective in terms of freedom from AF. Although CB ablation results in shorter index procedures times, durations of repeat ablation are significantly longer.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Venas Pulmonares
/
Fibrilación Atrial
/
Ablación por Catéter
/
Criocirugía
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Cardiovasc Electrophysiol
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
FISIOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Japón