Comparative Effectiveness and Safety of Cryoablation Versus Radiofrequency Ablation Treatments for Persistent Atrial Fibrillation

Baimbetov, A; Bizhanov, K; Jukenova, A; Aubakirova, Aigul T.; Ualiyeva, Aliya; Sagatov, Inkar Ye.

doi:10.1016/j.amjcard.2022.08.031

Cited by 8 publications

(18 citation statements)

References 21 publications

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“…14 Comparative effectiveness of CRYO versus RF ablation in persistent AF was also reported in a cohort of 127 patients with a rigorous follow-up of 36 months with implantable loop recorders (ILR). 15 The subgroup of persistent AF in the FREEZE trial also did not exhibit statistically significant difference in the primary outcome. 16 In a metaanalysis of 2020, CRYO was supported as an effective alternative to RF ablation in persistent AF, with similar recurrence rate of ATA, less cardiac tamponade complication but more frequent phrenic nerve palsy.…”

Section: Discussionmentioning

confidence: 87%

“…| 1525 AF. [9][10][11][12][13][14][15][16][17] The largest up to date multicentre registry of patients with persistent/long-standing AF treated with CRYO, included 609 patients and reported an arrhythmia-free survival of 62% at 24 months. 12 A previous meta-analysis of 11 studies estimated the success rate of CRYO in persistent AF to be 68.9% at a follow-up of 16.7 ± 3 months.…”

Section: Discussionmentioning

confidence: 99%

“…A significant difference existed between the two groups regarding the procedure time with CRYO being the less timeconsuming procedure (75. 15 Complications were scarce in the cohort, with only one patient in the RF group experiencing postprocedural pericardial effusion that was not hemodynamically significant and was treated conservatively (Table 2).…”

Section: Secondary Endpoints: Procedures Time Fluoroscopy Time Compli...mentioning

confidence: 99%

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Radiofrequency versus cryoballoon catheter ablation in patients with persistent atrial fibrillation: A randomized trial

Mililis

Kariki

Saplaouras

et al. 2023

Cardiovasc electrophysiol

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Introduction Patients with persistent atrial fibrillation (AF) represent a challenging population for rhythm control therapies. Catheter ablation (CA) with pulmonary vein isolation (PVI) is an effective treatment option for the reduction of the arrhythmic burden. Data regarding the comparability between radiofrequency (RF) and cryoballoon ablation (CRYO) in persistent AF are limited. Methods This is a prospective, randomized, single‐center study designed to compare the efficacy in terms of rhythm control between RF and CRYO in persistent AF. Eligible participants were randomized 2:1 in two arms: RF and CRYO. The primary endpoint of the study was arrhythmia relapse in the early postprocedural period (first 3 months) and in the middle term follow‐up (3 months to 12 months). Secondary endpoints included procedure duration, fluoroscopy time, and complications. Results A total of 199 patients participated in the study (133 patients in the RF arm, 66 in the CRYO arm). No statistically significant difference occurred between the two groups regarding the primary endpoint (recurrences ≤3 months: 35.5% RF vs. 37.9% CRYO, p .755, recurrences >3 months: 26.3% RF vs. 27.3% CRYO, p .999). From the secondary endpoints, CRYO was a procedure of significantly shorter duration (75.15 ± 17.21 in CRYO vs. 136.6 ± 43.33 in RF group, p < .05). Conclusion CRYO and RF ablation appear to be equally effective for rhythm control in patients with persistent AF. CRYO ablation is advantageous in terms of procedure duration.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Secondary Endpoints: Procedures Time Fluoroscopy Time Compli...mentioning

confidence: 99%

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Radiofrequency versus cryoballoon catheter ablation in patients with persistent atrial fibrillation: A randomized trial

Mililis

Kariki

Saplaouras

et al. 2023

Cardiovasc electrophysiol

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“…Furthermore, the included population has a relatively high proportion of patients with paroxysmal atrial fibrillation. Patients with persistent atrial fibrillation require longer surgery time and more complex surgical procedures(such as linear ablation, Marshall ligament) could be be accompanied by higher complication rates [29,30] . Advances in ablation technology, such as irrigation and contact force sensing, as well as better management of AF risk factors may have contributed to this improvement [31] , which is also the cause of fewer surgical complications.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the pathogenesis of AF may differ between young and old AF patients [6] . Optimizing the effectiveness and safety of catheter ablation requires patient stratification and individualized therapy [7] . However, there is a scarcity of data from a large cohort study of younger AF patients on the effectiveness and safety of catheter ablation.…”

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confidence: 99%

Catheter ablation of atrial fibrillation in the young: a systematic review and meta-analysis

Zhan

Zheng

Huang

et al. 2023

Preprint

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Aims The differences in the clinical outcomes of rhythm and safety after catheter ablation in young and old atrial fibrillation(AF) patients remain unclear. The purpose of this study was to compare the clinical outcomes of catheter ablation for in young and old AF patients. Methods and results The Medline and EMBASE databases were searched for published articles up to Octomber 2022. Studies that met our predefined inclusion criteria were included. The primary endpoints were freedom from AF/atrial tachycardia (AT) recurrence, safety ouctcomes including the stroke/transient ischaemic attack (TIA), cardiac tamponade and pericardial effusion. After literature search and detailed assessment, 6 studies (9982 patients) were identified. Our analyses showed that the rate of freedom from AF/AT recurrence was higher in young than old AF patients after ablation [odds ratio (OR): 0.58, 95% confidence interval (CI) 0.36–0.92; P -0.02]. Compared to older patients, there were similar rate of adverse outcomes including pericardial effusion /tamponade (OR=0.61, 95%CI 0.29-1.27,P=0.18), hematoma(OR=1.87, 95%CI 0.62,5.63, P=0.27) and stroke/ TIA rate(OR=0.25, 95%CI 0.05,1.41, P=0.12) . Conclusions In younger atrial fibrillation patients, there is a lower major complication rate and a comparable efficacy rate, with a greater chance of being AF free without antiarrhythmic drugs. These findings suggest that it may be appropriate to consider ablative therapy as first-line therapy in this age group.

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2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation

Tzeis,

Gerstenfeld,

Kalman

et al. 2024

J Interv Card Electrophysiol

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Comparative Effectiveness and Safety of Cryoablation Versus Radiofrequency Ablation Treatments for Persistent Atrial Fibrillation

Cited by 8 publications

References 21 publications

Radiofrequency versus cryoballoon catheter ablation in patients with persistent atrial fibrillation: A randomized trial

Radiofrequency versus cryoballoon catheter ablation in patients with persistent atrial fibrillation: A randomized trial

Catheter ablation of atrial fibrillation in the young: a systematic review and meta-analysis

2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation

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