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Outcomes of cryoballoon or radiofrequency ablation in symptomatic paroxysmal or persistent atrial fibrillation

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Outcomes of cryoballoon or radiofrequency ablation in symptomatic paroxysmal or persistent atrial fibrillation. / Hoffmann, Ellen; Straube, Florian; Wegscheider, Karl; Kuniss, Malte; Andresen, Dietrich; Wu, Li-Qun; Tebbenjohanns, Jürgen; Noelker, Georg; Tilz, Roland Richard; Chun, Julian Kyoung Ryul; Franke, Andreas; Stellbrink, Christoph; Garcia-Alberola, Arcadi; Dorwarth, Uwe; Metzner, Andreas; Ouarrak, Taoufik; Brachmann, Johannes; Kuck, Karl-Heinz; Senges, Jochen; FREEZE Cohort Study Investigators .

In: EUROPACE, Vol. 21, No. 9, 01.09.2019, p. 1313-1324.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Hoffmann, E, Straube, F, Wegscheider, K, Kuniss, M, Andresen, D, Wu, L-Q, Tebbenjohanns, J, Noelker, G, Tilz, RR, Chun, JKR, Franke, A, Stellbrink, C, Garcia-Alberola, A, Dorwarth, U, Metzner, A, Ouarrak, T, Brachmann, J, Kuck, K-H, Senges, J & FREEZE Cohort Study Investigators 2019, 'Outcomes of cryoballoon or radiofrequency ablation in symptomatic paroxysmal or persistent atrial fibrillation', EUROPACE, vol. 21, no. 9, pp. 1313-1324. https://doi.org/10.1093/europace/euz155

APA

Hoffmann, E., Straube, F., Wegscheider, K., Kuniss, M., Andresen, D., Wu, L-Q., Tebbenjohanns, J., Noelker, G., Tilz, R. R., Chun, J. K. R., Franke, A., Stellbrink, C., Garcia-Alberola, A., Dorwarth, U., Metzner, A., Ouarrak, T., Brachmann, J., Kuck, K-H., Senges, J., & FREEZE Cohort Study Investigators (2019). Outcomes of cryoballoon or radiofrequency ablation in symptomatic paroxysmal or persistent atrial fibrillation. EUROPACE, 21(9), 1313-1324. https://doi.org/10.1093/europace/euz155

Vancouver

Hoffmann E, Straube F, Wegscheider K, Kuniss M, Andresen D, Wu L-Q et al. Outcomes of cryoballoon or radiofrequency ablation in symptomatic paroxysmal or persistent atrial fibrillation. EUROPACE. 2019 Sep 1;21(9):1313-1324. https://doi.org/10.1093/europace/euz155

Bibtex

@article{255d2258a855499ab64863ae436cf0b3,
title = "Outcomes of cryoballoon or radiofrequency ablation in symptomatic paroxysmal or persistent atrial fibrillation",
abstract = "AIMS: To evaluate the effectiveness and safety of cryoballoon ablation (CBA) compared with radiofrequency ablation (RFA) for symptomatic paroxysmal or drug-refractory persistent atrial fibrillation (AF).METHODS AND RESULTS: Prospective cluster cohort study in experienced CBA and RFA centres. Primary endpoint was 'atrial arrhythmia recurrence', secondary endpoints were as follows: procedural results, safety, and clinical course. A total of 4189 patients were included: CBA 2329 (55.6%) and RFA 1860 (44.4%). Cryoballoon ablation population was younger, with fewer comorbidities. Procedure time was longer in the RFA group (P = 0.01). Radiation exposure was 2487 (CBA) and 1792 cGycm2 (RFA) (P < 0.001). Follow-up duration was 441 (CBA) and 511 days (RFA) (P < 0.0001). Primary endpoint occurred in 30.7% (CBA) and 39.4% patients (RFA) [adjusted hazard ratio (adjHR) 0.85, 95% confidence interval (CI) 0.70-1.04; P = 0.12). In paroxysmal AF, CBA resulted in a lower risk of recurrence (adjHR 0.80, 95% CI 0.64-0.99; P = 0.047). In persistent AF, the primary outcome was not different between groups. Major adverse cardiovascular and cerebrovascular event rates were 1.0% (CBA) and 2.8% (RFA) (adjHR 0.53, 95% CI 0.26-1.10; P = 0.088). Re-ablations (adjHR 0.46, 95% CI 0.34-0.61; P < 0.0001) and adverse events during follow-up (adjHR 0.64, 95% CI 0.48-0.88; P = 0.005) were less common after CBA. Higher rehospitalization rates with RFA were caused by re-ablations.CONCLUSIONS: The primary endpoint did not differ between CBA and RFA. Cryoballoon ablation was completed rapidly; the radiation exposure was greater. Rehospitalization due to re-ablations and adverse events during follow-up were observed significantly less frequently after CBA than after RFA. Subgroup analysis suggested a lower risk of recurrence after CBA in paroxysmal AF.TRIAL REGISTRATION: ClinicalTrials.gov (NCT01360008), https://clinicaltrials.gov/ct2/show/NCT01360008.",
author = "Ellen Hoffmann and Florian Straube and Karl Wegscheider and Malte Kuniss and Dietrich Andresen and Li-Qun Wu and J{\"u}rgen Tebbenjohanns and Georg Noelker and Tilz, {Roland Richard} and Chun, {Julian Kyoung Ryul} and Andreas Franke and Christoph Stellbrink and Arcadi Garcia-Alberola and Uwe Dorwarth and Andreas Metzner and Taoufik Ouarrak and Johannes Brachmann and Karl-Heinz Kuck and Jochen Senges and {FREEZE Cohort Study Investigators}",
note = "{\textcopyright} The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.",
year = "2019",
month = sep,
day = "1",
doi = "10.1093/europace/euz155",
language = "English",
volume = "21",
pages = "1313--1324",
journal = "EUROPACE",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "9",

}

RIS

TY - JOUR

T1 - Outcomes of cryoballoon or radiofrequency ablation in symptomatic paroxysmal or persistent atrial fibrillation

AU - Hoffmann, Ellen

AU - Straube, Florian

AU - Wegscheider, Karl

AU - Kuniss, Malte

AU - Andresen, Dietrich

AU - Wu, Li-Qun

AU - Tebbenjohanns, Jürgen

AU - Noelker, Georg

AU - Tilz, Roland Richard

AU - Chun, Julian Kyoung Ryul

AU - Franke, Andreas

AU - Stellbrink, Christoph

AU - Garcia-Alberola, Arcadi

AU - Dorwarth, Uwe

AU - Metzner, Andreas

AU - Ouarrak, Taoufik

AU - Brachmann, Johannes

AU - Kuck, Karl-Heinz

AU - Senges, Jochen

AU - FREEZE Cohort Study Investigators

N1 - © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - AIMS: To evaluate the effectiveness and safety of cryoballoon ablation (CBA) compared with radiofrequency ablation (RFA) for symptomatic paroxysmal or drug-refractory persistent atrial fibrillation (AF).METHODS AND RESULTS: Prospective cluster cohort study in experienced CBA and RFA centres. Primary endpoint was 'atrial arrhythmia recurrence', secondary endpoints were as follows: procedural results, safety, and clinical course. A total of 4189 patients were included: CBA 2329 (55.6%) and RFA 1860 (44.4%). Cryoballoon ablation population was younger, with fewer comorbidities. Procedure time was longer in the RFA group (P = 0.01). Radiation exposure was 2487 (CBA) and 1792 cGycm2 (RFA) (P < 0.001). Follow-up duration was 441 (CBA) and 511 days (RFA) (P < 0.0001). Primary endpoint occurred in 30.7% (CBA) and 39.4% patients (RFA) [adjusted hazard ratio (adjHR) 0.85, 95% confidence interval (CI) 0.70-1.04; P = 0.12). In paroxysmal AF, CBA resulted in a lower risk of recurrence (adjHR 0.80, 95% CI 0.64-0.99; P = 0.047). In persistent AF, the primary outcome was not different between groups. Major adverse cardiovascular and cerebrovascular event rates were 1.0% (CBA) and 2.8% (RFA) (adjHR 0.53, 95% CI 0.26-1.10; P = 0.088). Re-ablations (adjHR 0.46, 95% CI 0.34-0.61; P < 0.0001) and adverse events during follow-up (adjHR 0.64, 95% CI 0.48-0.88; P = 0.005) were less common after CBA. Higher rehospitalization rates with RFA were caused by re-ablations.CONCLUSIONS: The primary endpoint did not differ between CBA and RFA. Cryoballoon ablation was completed rapidly; the radiation exposure was greater. Rehospitalization due to re-ablations and adverse events during follow-up were observed significantly less frequently after CBA than after RFA. Subgroup analysis suggested a lower risk of recurrence after CBA in paroxysmal AF.TRIAL REGISTRATION: ClinicalTrials.gov (NCT01360008), https://clinicaltrials.gov/ct2/show/NCT01360008.

AB - AIMS: To evaluate the effectiveness and safety of cryoballoon ablation (CBA) compared with radiofrequency ablation (RFA) for symptomatic paroxysmal or drug-refractory persistent atrial fibrillation (AF).METHODS AND RESULTS: Prospective cluster cohort study in experienced CBA and RFA centres. Primary endpoint was 'atrial arrhythmia recurrence', secondary endpoints were as follows: procedural results, safety, and clinical course. A total of 4189 patients were included: CBA 2329 (55.6%) and RFA 1860 (44.4%). Cryoballoon ablation population was younger, with fewer comorbidities. Procedure time was longer in the RFA group (P = 0.01). Radiation exposure was 2487 (CBA) and 1792 cGycm2 (RFA) (P < 0.001). Follow-up duration was 441 (CBA) and 511 days (RFA) (P < 0.0001). Primary endpoint occurred in 30.7% (CBA) and 39.4% patients (RFA) [adjusted hazard ratio (adjHR) 0.85, 95% confidence interval (CI) 0.70-1.04; P = 0.12). In paroxysmal AF, CBA resulted in a lower risk of recurrence (adjHR 0.80, 95% CI 0.64-0.99; P = 0.047). In persistent AF, the primary outcome was not different between groups. Major adverse cardiovascular and cerebrovascular event rates were 1.0% (CBA) and 2.8% (RFA) (adjHR 0.53, 95% CI 0.26-1.10; P = 0.088). Re-ablations (adjHR 0.46, 95% CI 0.34-0.61; P < 0.0001) and adverse events during follow-up (adjHR 0.64, 95% CI 0.48-0.88; P = 0.005) were less common after CBA. Higher rehospitalization rates with RFA were caused by re-ablations.CONCLUSIONS: The primary endpoint did not differ between CBA and RFA. Cryoballoon ablation was completed rapidly; the radiation exposure was greater. Rehospitalization due to re-ablations and adverse events during follow-up were observed significantly less frequently after CBA than after RFA. Subgroup analysis suggested a lower risk of recurrence after CBA in paroxysmal AF.TRIAL REGISTRATION: ClinicalTrials.gov (NCT01360008), https://clinicaltrials.gov/ct2/show/NCT01360008.

U2 - 10.1093/europace/euz155

DO - 10.1093/europace/euz155

M3 - SCORING: Journal article

C2 - 31199860

VL - 21

SP - 1313

EP - 1324

JO - EUROPACE

JF - EUROPACE

SN - 1099-5129

IS - 9

ER -