Cryoballoon versus Radiofrequency Catheter Ablation in Atrial Fibrillation: A Meta-Analysis

Rhanderson Cardoso, Rodrigo Mendirichaga, Gilson Fernandes, Chris Healy, Litsa K. Lambrakos, Juan Viles Gonzalez, Jeffrey Goldberger, Raul Mitrani

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Introduction: Radiofrequency (RF) and cryoballoon (CB) catheter ablation are effective for pulmonary vein isolation (PVI) in atrial fibrillation (AF). This report presents an updated meta-analysis comparing the efficacy and safety of CB versus RF ablations in AF. Methods: Databases and conference abstracts were systematically searched for studies that directly compared CB and RF PVI, and reported safety or efficacy outcomes in follow-up ≥12 months. Recurrent atrial tachyarrhythmias (AT) were defined as AF, atrial flutter, or atrial tachycardia. Results: Twenty-two studies and 8,668 patients were included. Freedom from AT was not significantly different between CB and RF ablations in the pooled population (OR 1.12; 95%CI 0.97–1.29; P = 0.13) and in randomized trials (OR 1.0; 95%CI 0.65–1.56; P = 0.99). Second-generation CB (CB2; 78.1%) and contact-force (CF) sensing RF (78.2%) have improved procedure success rate as compared to first-generation technology (57.9% CB, 58.1% RF). As compared to CF-RF, CB2 demonstrated similar freedom from recurrent AT (OR 1.04; 95%CI 0.71–1.51; P = 0.84). The incidence of pericardial effusions (OR 0.44; 95%CI 0.28–0.69; P < 0.01), tamponade (OR 0.31; 95%CI 0.15–0.64; P < 0.01), and non-AF AT (OR 0.46; 95%CI 0.26–0.83; P < 0.01) were significantly lower with CB ablation, whereas transient phrenic nerve palsy was more incident after CB (OR 7.40; 95%CI 2.56–21.34; P < 0.01). Conclusion: There was comparable freedom from AT between CB and RF in patients with AF undergoing PVI. Additionally, freedom from AT was similar between CB2 and CF-RF. However, CB was associated with a lower incidence of pericardial effusions or tamponade, albeit with a higher rate of transient phrenic nerve palsies.

Original languageEnglish (US)
Pages (from-to)1151-1159
Number of pages9
JournalJournal of Cardiovascular Electrophysiology
Volume27
Issue number10
DOIs
StatePublished - Oct 1 2016

Fingerprint

Catheter Ablation
Tachycardia
Atrial Fibrillation
Meta-Analysis
Pulmonary Veins
Phrenic Nerve
Pericardial Effusion
Paralysis
Safety
Cardiac Tamponade
Atrial Flutter
Incidence
Databases
Technology
Population

Keywords

  • atrial fibrillation
  • catheter ablation
  • complication
  • cryoballoon
  • pulmonary vein isolation
  • radiofrequency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Cardoso, R., Mendirichaga, R., Fernandes, G., Healy, C., Lambrakos, L. K., Viles Gonzalez, J., ... Mitrani, R. (2016). Cryoballoon versus Radiofrequency Catheter Ablation in Atrial Fibrillation: A Meta-Analysis. Journal of Cardiovascular Electrophysiology, 27(10), 1151-1159. https://doi.org/10.1111/jce.13047

Cryoballoon versus Radiofrequency Catheter Ablation in Atrial Fibrillation : A Meta-Analysis. / Cardoso, Rhanderson; Mendirichaga, Rodrigo; Fernandes, Gilson; Healy, Chris; Lambrakos, Litsa K.; Viles Gonzalez, Juan; Goldberger, Jeffrey; Mitrani, Raul.

In: Journal of Cardiovascular Electrophysiology, Vol. 27, No. 10, 01.10.2016, p. 1151-1159.

Research output: Contribution to journalArticle

Cardoso, R, Mendirichaga, R, Fernandes, G, Healy, C, Lambrakos, LK, Viles Gonzalez, J, Goldberger, J & Mitrani, R 2016, 'Cryoballoon versus Radiofrequency Catheter Ablation in Atrial Fibrillation: A Meta-Analysis', Journal of Cardiovascular Electrophysiology, vol. 27, no. 10, pp. 1151-1159. https://doi.org/10.1111/jce.13047
Cardoso R, Mendirichaga R, Fernandes G, Healy C, Lambrakos LK, Viles Gonzalez J et al. Cryoballoon versus Radiofrequency Catheter Ablation in Atrial Fibrillation: A Meta-Analysis. Journal of Cardiovascular Electrophysiology. 2016 Oct 1;27(10):1151-1159. https://doi.org/10.1111/jce.13047
Cardoso, Rhanderson ; Mendirichaga, Rodrigo ; Fernandes, Gilson ; Healy, Chris ; Lambrakos, Litsa K. ; Viles Gonzalez, Juan ; Goldberger, Jeffrey ; Mitrani, Raul. / Cryoballoon versus Radiofrequency Catheter Ablation in Atrial Fibrillation : A Meta-Analysis. In: Journal of Cardiovascular Electrophysiology. 2016 ; Vol. 27, No. 10. pp. 1151-1159.
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N2 - Introduction: Radiofrequency (RF) and cryoballoon (CB) catheter ablation are effective for pulmonary vein isolation (PVI) in atrial fibrillation (AF). This report presents an updated meta-analysis comparing the efficacy and safety of CB versus RF ablations in AF. Methods: Databases and conference abstracts were systematically searched for studies that directly compared CB and RF PVI, and reported safety or efficacy outcomes in follow-up ≥12 months. Recurrent atrial tachyarrhythmias (AT) were defined as AF, atrial flutter, or atrial tachycardia. Results: Twenty-two studies and 8,668 patients were included. Freedom from AT was not significantly different between CB and RF ablations in the pooled population (OR 1.12; 95%CI 0.97–1.29; P = 0.13) and in randomized trials (OR 1.0; 95%CI 0.65–1.56; P = 0.99). Second-generation CB (CB2; 78.1%) and contact-force (CF) sensing RF (78.2%) have improved procedure success rate as compared to first-generation technology (57.9% CB, 58.1% RF). As compared to CF-RF, CB2 demonstrated similar freedom from recurrent AT (OR 1.04; 95%CI 0.71–1.51; P = 0.84). The incidence of pericardial effusions (OR 0.44; 95%CI 0.28–0.69; P < 0.01), tamponade (OR 0.31; 95%CI 0.15–0.64; P < 0.01), and non-AF AT (OR 0.46; 95%CI 0.26–0.83; P < 0.01) were significantly lower with CB ablation, whereas transient phrenic nerve palsy was more incident after CB (OR 7.40; 95%CI 2.56–21.34; P < 0.01). Conclusion: There was comparable freedom from AT between CB and RF in patients with AF undergoing PVI. Additionally, freedom from AT was similar between CB2 and CF-RF. However, CB was associated with a lower incidence of pericardial effusions or tamponade, albeit with a higher rate of transient phrenic nerve palsies.

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