TY - JOUR
T1 - First-line catheter ablation of paroxysmal atrial fibrillation
T2 - Outcome of radiofrequency vs. cryoballoon pulmonary vein isolation
AU - Straube, Florian
AU - Dorwarth, Uwe
AU - Ammar-Busch, Sonia
AU - Peter, Timo
AU - Noelker, Georg
AU - Massa, Thomas
AU - Kuniss, Malte
AU - Ewertsen, Niels Christian
AU - Chun, Kyoung Ryul Julian
AU - Tebbenjohanns, Juergen
AU - Tilz, Roland
AU - Kuck, Karl Heinz
AU - Ouarrak, Taoufik
AU - Senges, Jochen
AU - Hoffmann, Ellen
N1 - Publisher Copyright:
© The Author 2015.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Aims First-line ablation prior to antiarrhythmic drug (AAD) therapy is an option for symptomatic paroxysmal atrial fibrillation (PAF); however, the optimal ablation technique, radiofrequency (RF), or cryoballoon (CB) has to be determined. Methods and results The FREEZE Cohort Study compares RF and CB ablation. Treatment-naïve patients were documented in the FREEZEplus Registry. Periprocedural data and outcome were analysed. From 2011 to 2014, a total of 373/4184 (8.9%) patients with PAF naïve to AAD were identified. Pulmonary vein isolation (PVI) was performed with RF (n = 180) or CB (n = 193). In the RF group, patients were older (65 vs. 61 years, P < 0.01) compared with the CB group. The procedure time was significantly shorter and radiation exposure higher in the CB group. Major adverse events occurred in 1.6% (CB) and 3.7% (RF) of patients (P = 0.22). AF/atrial tachycardia (AT) recurrence until discharge was 4.5% (RF) and 8.5% (CB, P = 0.2). Follow-up (FU) ≥12 months was available in 99 (RF) and 107 (CB) patients. After 1.4 years of FU, freedom from AF/atrial tachycardia (AT) was 61% (RF) and 71% (CB, P = 0.11). In the RF group, more patients underwent cardioversion, and a trend for more repeat ablations was observed. Persistent phrenic nerve palsy was observed in one patient treated by CB. Conclusion First-line ablation for PAF is safe and effective with either RF or CB. The procedure was faster with the CB, but the radiation exposure was higher. Although there was a trend for more recurrences and complications in the RF group, a more favourable risk profile in patients undergoing CB ablation might have biased the results. Published on behalf of the European Society of Cardiology. All rights reserved.
AB - Aims First-line ablation prior to antiarrhythmic drug (AAD) therapy is an option for symptomatic paroxysmal atrial fibrillation (PAF); however, the optimal ablation technique, radiofrequency (RF), or cryoballoon (CB) has to be determined. Methods and results The FREEZE Cohort Study compares RF and CB ablation. Treatment-naïve patients were documented in the FREEZEplus Registry. Periprocedural data and outcome were analysed. From 2011 to 2014, a total of 373/4184 (8.9%) patients with PAF naïve to AAD were identified. Pulmonary vein isolation (PVI) was performed with RF (n = 180) or CB (n = 193). In the RF group, patients were older (65 vs. 61 years, P < 0.01) compared with the CB group. The procedure time was significantly shorter and radiation exposure higher in the CB group. Major adverse events occurred in 1.6% (CB) and 3.7% (RF) of patients (P = 0.22). AF/atrial tachycardia (AT) recurrence until discharge was 4.5% (RF) and 8.5% (CB, P = 0.2). Follow-up (FU) ≥12 months was available in 99 (RF) and 107 (CB) patients. After 1.4 years of FU, freedom from AF/atrial tachycardia (AT) was 61% (RF) and 71% (CB, P = 0.11). In the RF group, more patients underwent cardioversion, and a trend for more repeat ablations was observed. Persistent phrenic nerve palsy was observed in one patient treated by CB. Conclusion First-line ablation for PAF is safe and effective with either RF or CB. The procedure was faster with the CB, but the radiation exposure was higher. Although there was a trend for more recurrences and complications in the RF group, a more favourable risk profile in patients undergoing CB ablation might have biased the results. Published on behalf of the European Society of Cardiology. All rights reserved.
UR - http://www.scopus.com/inward/record.url?scp=84965121106&partnerID=8YFLogxK
U2 - 10.1093/europace/euv271
DO - 10.1093/europace/euv271
M3 - Journal articles
C2 - 26504108
AN - SCOPUS:84965121106
SN - 1099-5129
VL - 18
SP - 368
EP - 375
JO - Europace
JF - Europace
IS - 3
ER -