Cryoballoon ablation versus radiofrequency catheter ablation for pulmonary vein isolation as first invasive treatment in patients with atrial fibrillation: a matched group comparison.

Berretty, W.L. (2014) Cryoballoon ablation versus radiofrequency catheter ablation for pulmonary vein isolation as first invasive treatment in patients with atrial fibrillation: a matched group comparison. thesis, Medicine.

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Abstract

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia. Since AF is associated with significant morbidities and mortality it has a major impact on public health. Radiofrequency catheter ablation (RF) is the most common used technique for pulmonary vein isolation (PVI) as treatment for AF. The second generation cryoballoon (CRYO) has recently been introduced for pulmonary vein isolation (PVI). In this study, we evaluated 6-month outcome for our first CRYO experience and compared this to RF treated patients. Methods The first 33 patients who underwent CRYO ablation in the University Medical Center Groningen were retrospectively matched (1:2) according to age, sex and duration of AF with 66 patients who underwent RF. Freedom of AF was defined as no AF on Holter monitoring or electrocardiogram and no visit to emergency department for AF. Results Baseline characteristics were not different between CRYO and RF. In all patients the current ablation was the first PVI. Mean age was 57±9years, and 79% were males. AF was paroxysmal in 77 (78%) and persistent in 22 (22%) patients. As compared with RF, the CRYO procedure time was shorter (147±37 vs. 200±43min, p<0.001), but fluoroscopy time longer (67±32 vs. 21±11min, P<0.001). Complications occurred in six (18%) CRYO and in four (6%) RF patients. Holter follow-up was complete in 99% of patients. Thirty-nine percent of the CRYO and 36% of the RF patients were free of AF without antiarrhythmic drugs(AAD)(p=0.8). Success with AAD was observed in 70% of the CRYO group and in 56% of the RF group (p=0.3). In the CRYO group fluoroscopy time decreased with experience (76±31 vs. 56±33min, p=0.2, for respectively first vs. last 10 cases). Conclusion The first experience with the cryoballoon for PVI resulted in comparable success rates as RF ablation and procedure time was significantly shorter.

Item Type:	Thesis (Thesis)
Supervisor name:	Blaauw, Y. and Mulder, B.A. and Gelder, I.C. van and department of Cardiology UMCG
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:48
Last Modified:	25 Jun 2020 10:48
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/902

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