Influence of energy source on early atrial fibrillation recurrences: a comparison of cryoballoon vs. radiofrequency current energy ablation with the endpoint of unexcitability in pulmonary vein isolation
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Influence of energy source on early atrial fibrillation recurrences: a comparison of cryoballoon vs. radiofrequency current energy ablation with the endpoint of unexcitability in pulmonary vein isolation. / Gunawardene, Melanie A; Hoffmann, Boris A; Schaeffer, Benjamin; Chung, Da-Un; Moser, Julia; Akbulak, Ruken Oezge; Jularic, Mario; Eickholt, Christian; Nuehrich, Jana; Meyer, Christian; Willems, Stephan.
in: EUROPACE, Jahrgang 20, Nr. 1, 01.01.2018, S. 43-49.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Influence of energy source on early atrial fibrillation recurrences: a comparison of cryoballoon vs. radiofrequency current energy ablation with the endpoint of unexcitability in pulmonary vein isolation
AU - Gunawardene, Melanie A
AU - Hoffmann, Boris A
AU - Schaeffer, Benjamin
AU - Chung, Da-Un
AU - Moser, Julia
AU - Akbulak, Ruken Oezge
AU - Jularic, Mario
AU - Eickholt, Christian
AU - Nuehrich, Jana
AU - Meyer, Christian
AU - Willems, Stephan
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Introduction: Comparative data of early recurrence rates of atrial fibrillation (ERAF) following second-generation cryoballoon (CB-G2) and radiofrequency current (RFC) ablation for pulmonary vein isolation (PVI) in paroxysmal AF (PAF) are rare. We randomized PAF patients into either PVI with CB-G2 (group 1) or PVI with a combined RFC-approach applying contact force (CF) with the endpoint of unexcitability (group 2) to investigate ERAF.Methods and results: In group 1 (n = 30), CB-G2-PVI was performed. After CF-PVI in group 2 (n = 30), bipolar pacing on the ablation line and additional ablation until unexcitability was conducted. Follow-up included 48 h of in-hospital monitoring followed by 5-day Holter ECGs 1, 2, 3, 6, 12 months postablation to evaluate ERAF. Acute PVI was reached in 100% of group 2 and in 99% of group 1. Shorter procedure durations (98.0 ± 21.9 vs. 114.3 ± 18.7 min, P < 0.05) but extended fluoroscopy times (15.4 ± 3.9 vs. 10.0 ± 4.3 min, P < 0.05) were found in the CB-G2 group. Ten non-severe complications occurred (6 vs. 4 in group 1 and 2, P = 0.73). In group 2, five patients suffered from ERAF vs. seven patients in group 1 (P = 0.67). The time until the occurrence of ERAF was shorter in group 2 (1 day (q1-q3: 1-4.5)) when compared with group 1 (22 (q1-q3: 6-54) days, P = 0.025).Conclusion: ERAF rates were equal among groups; however, they occurred earlier in the initial phase after RFC ablation when compared with CB-G2. PVI utilizing cryoablation is associated with shorter procedure durations but extended fluoroscopy time while being similarly secure.
AB - Introduction: Comparative data of early recurrence rates of atrial fibrillation (ERAF) following second-generation cryoballoon (CB-G2) and radiofrequency current (RFC) ablation for pulmonary vein isolation (PVI) in paroxysmal AF (PAF) are rare. We randomized PAF patients into either PVI with CB-G2 (group 1) or PVI with a combined RFC-approach applying contact force (CF) with the endpoint of unexcitability (group 2) to investigate ERAF.Methods and results: In group 1 (n = 30), CB-G2-PVI was performed. After CF-PVI in group 2 (n = 30), bipolar pacing on the ablation line and additional ablation until unexcitability was conducted. Follow-up included 48 h of in-hospital monitoring followed by 5-day Holter ECGs 1, 2, 3, 6, 12 months postablation to evaluate ERAF. Acute PVI was reached in 100% of group 2 and in 99% of group 1. Shorter procedure durations (98.0 ± 21.9 vs. 114.3 ± 18.7 min, P < 0.05) but extended fluoroscopy times (15.4 ± 3.9 vs. 10.0 ± 4.3 min, P < 0.05) were found in the CB-G2 group. Ten non-severe complications occurred (6 vs. 4 in group 1 and 2, P = 0.73). In group 2, five patients suffered from ERAF vs. seven patients in group 1 (P = 0.67). The time until the occurrence of ERAF was shorter in group 2 (1 day (q1-q3: 1-4.5)) when compared with group 1 (22 (q1-q3: 6-54) days, P = 0.025).Conclusion: ERAF rates were equal among groups; however, they occurred earlier in the initial phase after RFC ablation when compared with CB-G2. PVI utilizing cryoablation is associated with shorter procedure durations but extended fluoroscopy time while being similarly secure.
KW - Action Potentials
KW - Aged
KW - Atrial Fibrillation/diagnosis
KW - Cardiac Catheters
KW - Cardiac Pacing, Artificial
KW - Catheter Ablation/adverse effects
KW - Cryosurgery/adverse effects
KW - Electrocardiography, Ambulatory
KW - Electrophysiologic Techniques, Cardiac
KW - Equipment Design
KW - Female
KW - Fluoroscopy
KW - Germany
KW - Heart Rate
KW - Humans
KW - Male
KW - Middle Aged
KW - Operative Time
KW - Pilot Projects
KW - Prospective Studies
KW - Pulmonary Veins/physiopathology
KW - Radiography, Interventional
KW - Recurrence
KW - Risk Factors
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1093/europace/euw307
DO - 10.1093/europace/euw307
M3 - SCORING: Journal article
C2 - 27742775
VL - 20
SP - 43
EP - 49
JO - EUROPACE
JF - EUROPACE
SN - 1099-5129
IS - 1
ER -
