Cryoballoon versus radiofrequency catheter ablation for paroxysmal atrial fibrillation

Jeremiah Wasserlauf, Daniel J. Pelchovitz, John Rhyner, Nishant Verma, Martha Bohn, Zhi Li, Rishi Arora, Alexandru B. Chicos, Jeffrey Goldberger, Susan S. Kim, Albert C. Lin, Bradley P. Knight, Rod S. Passman

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background Catheter ablation is an established treatment for atrial fibrillation (AF). Cryoballoon ablation (CBA) has emerged as an alternative to radiofrequency ablation (RFA). However, there are few data comparing these modalities for treatment of paroxysmal AF (pAF) in the U.S. population. The purpose of this study was to compare procedural times, safety, and efficacy of CBA against RFA. Methods A single-center prospective cohort study evaluated patients who underwent catheter ablation for pAF using CBA or RFA between January 1, 2010 and October 31, 2013. Patients with prior ablation and those without rhythm follow-up for at least 3 months were excluded. The primary end point was freedom from AF, atrial flutter, and atrial tachycardia (FFAF) >30 seconds after a 3-month blanking period without requirement for antiarrhythmic drugs. We also compared rates of successful pulmonary vein isolation (PVI), fluoroscopy and procedure times, and major complication rates. Results A total of 201 patients were included (CBA = 101, RFA = 100). The rate of successful PVI was 99.3% in CBA versus 97.4% in RFA (P = 0.08). Procedure times were shorter with CBA (192.9 ± 44.0 minutes vs 283.7 ± 78.0 minutes, P < 0.001) as well as total fluoroscopy times (46.0 ± 22.4 minutes vs 73.0 ± 30.1 minutes, P < 0.001). Overall complication rates were equivalent; however, fewer cardiac perforations occurred with CBA (0% vs 4%, P = 0.042). The 1-year FFAF rates were 60.3% for CBA and 61.1% for RFA (log rank P = 0.93). Conclusion CBA was associated with equivalent 1-year FFAF rate as RFA for pAF. Procedure and fluoroscopy times were shorter for CBA and fewer cardiac perforations occurred.

Original languageEnglish (US)
Pages (from-to)483-489
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume38
Issue number4
DOIs
StatePublished - Apr 1 2015
Externally publishedYes

Fingerprint

Catheter Ablation
Atrial Fibrillation
Fluoroscopy
Pulmonary Veins
Atrial Flutter
Anti-Arrhythmia Agents
Tachycardia
Cohort Studies
Prospective Studies
Safety
Therapeutics
Population

Keywords

  • arrhythmias
  • atrial fibrillation
  • catheter ablation
  • cryoballoon ablation
  • radiofrequency ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Wasserlauf, J., Pelchovitz, D. J., Rhyner, J., Verma, N., Bohn, M., Li, Z., ... Passman, R. S. (2015). Cryoballoon versus radiofrequency catheter ablation for paroxysmal atrial fibrillation. PACE - Pacing and Clinical Electrophysiology, 38(4), 483-489. https://doi.org/10.1111/pace.12582

Cryoballoon versus radiofrequency catheter ablation for paroxysmal atrial fibrillation. / Wasserlauf, Jeremiah; Pelchovitz, Daniel J.; Rhyner, John; Verma, Nishant; Bohn, Martha; Li, Zhi; Arora, Rishi; Chicos, Alexandru B.; Goldberger, Jeffrey; Kim, Susan S.; Lin, Albert C.; Knight, Bradley P.; Passman, Rod S.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 38, No. 4, 01.04.2015, p. 483-489.

Research output: Contribution to journalArticle

Wasserlauf, J, Pelchovitz, DJ, Rhyner, J, Verma, N, Bohn, M, Li, Z, Arora, R, Chicos, AB, Goldberger, J, Kim, SS, Lin, AC, Knight, BP & Passman, RS 2015, 'Cryoballoon versus radiofrequency catheter ablation for paroxysmal atrial fibrillation', PACE - Pacing and Clinical Electrophysiology, vol. 38, no. 4, pp. 483-489. https://doi.org/10.1111/pace.12582
Wasserlauf, Jeremiah ; Pelchovitz, Daniel J. ; Rhyner, John ; Verma, Nishant ; Bohn, Martha ; Li, Zhi ; Arora, Rishi ; Chicos, Alexandru B. ; Goldberger, Jeffrey ; Kim, Susan S. ; Lin, Albert C. ; Knight, Bradley P. ; Passman, Rod S. / Cryoballoon versus radiofrequency catheter ablation for paroxysmal atrial fibrillation. In: PACE - Pacing and Clinical Electrophysiology. 2015 ; Vol. 38, No. 4. pp. 483-489.
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abstract = "Background Catheter ablation is an established treatment for atrial fibrillation (AF). Cryoballoon ablation (CBA) has emerged as an alternative to radiofrequency ablation (RFA). However, there are few data comparing these modalities for treatment of paroxysmal AF (pAF) in the U.S. population. The purpose of this study was to compare procedural times, safety, and efficacy of CBA against RFA. Methods A single-center prospective cohort study evaluated patients who underwent catheter ablation for pAF using CBA or RFA between January 1, 2010 and October 31, 2013. Patients with prior ablation and those without rhythm follow-up for at least 3 months were excluded. The primary end point was freedom from AF, atrial flutter, and atrial tachycardia (FFAF) >30 seconds after a 3-month blanking period without requirement for antiarrhythmic drugs. We also compared rates of successful pulmonary vein isolation (PVI), fluoroscopy and procedure times, and major complication rates. Results A total of 201 patients were included (CBA = 101, RFA = 100). The rate of successful PVI was 99.3{\%} in CBA versus 97.4{\%} in RFA (P = 0.08). Procedure times were shorter with CBA (192.9 ± 44.0 minutes vs 283.7 ± 78.0 minutes, P < 0.001) as well as total fluoroscopy times (46.0 ± 22.4 minutes vs 73.0 ± 30.1 minutes, P < 0.001). Overall complication rates were equivalent; however, fewer cardiac perforations occurred with CBA (0{\%} vs 4{\%}, P = 0.042). The 1-year FFAF rates were 60.3{\%} for CBA and 61.1{\%} for RFA (log rank P = 0.93). Conclusion CBA was associated with equivalent 1-year FFAF rate as RFA for pAF. Procedure and fluoroscopy times were shorter for CBA and fewer cardiac perforations occurred.",
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AU - Pelchovitz, Daniel J.

AU - Rhyner, John

AU - Verma, Nishant

AU - Bohn, Martha

AU - Li, Zhi

AU - Arora, Rishi

AU - Chicos, Alexandru B.

AU - Goldberger, Jeffrey

AU - Kim, Susan S.

AU - Lin, Albert C.

AU - Knight, Bradley P.

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N2 - Background Catheter ablation is an established treatment for atrial fibrillation (AF). Cryoballoon ablation (CBA) has emerged as an alternative to radiofrequency ablation (RFA). However, there are few data comparing these modalities for treatment of paroxysmal AF (pAF) in the U.S. population. The purpose of this study was to compare procedural times, safety, and efficacy of CBA against RFA. Methods A single-center prospective cohort study evaluated patients who underwent catheter ablation for pAF using CBA or RFA between January 1, 2010 and October 31, 2013. Patients with prior ablation and those without rhythm follow-up for at least 3 months were excluded. The primary end point was freedom from AF, atrial flutter, and atrial tachycardia (FFAF) >30 seconds after a 3-month blanking period without requirement for antiarrhythmic drugs. We also compared rates of successful pulmonary vein isolation (PVI), fluoroscopy and procedure times, and major complication rates. Results A total of 201 patients were included (CBA = 101, RFA = 100). The rate of successful PVI was 99.3% in CBA versus 97.4% in RFA (P = 0.08). Procedure times were shorter with CBA (192.9 ± 44.0 minutes vs 283.7 ± 78.0 minutes, P < 0.001) as well as total fluoroscopy times (46.0 ± 22.4 minutes vs 73.0 ± 30.1 minutes, P < 0.001). Overall complication rates were equivalent; however, fewer cardiac perforations occurred with CBA (0% vs 4%, P = 0.042). The 1-year FFAF rates were 60.3% for CBA and 61.1% for RFA (log rank P = 0.93). Conclusion CBA was associated with equivalent 1-year FFAF rate as RFA for pAF. Procedure and fluoroscopy times were shorter for CBA and fewer cardiac perforations occurred.

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