Cryoballoon Ablation as Initial Treatment for Atrial Fibrillation

Andrade, Jason G.; Wazni, Oussama; Kuniss, Malte; Hawkins, Nathaniel M.; Deyell, Marc W.; Chierchia, Gian‐Battista; Nissen, Steven; Verma, Atul; Wells, George A.; Turgeon, Ricky D.

doi:10.1016/j.jacc.2021.06.038

Cited by 78 publications

(69 citation statements)

References 57 publications

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“…15 This is an important consideration, as we increasingly consider the role of early rhythm control and first-line catheter ablation, an approach already proven to significantly improve arrhythmia and patient-reported outcomes, and significantly reduce subsequent health care resource use, as well. 11 Taken together, the findings of the present study add to the body of literature that argues that younger patients have potentially more to gain from catheter ablation.…”

supporting

confidence: 69%

Atrial Fibrillation Ablation: Aiming to Improve Quantity and Quality of Life

Andrade

Macle

2022

Circulation

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supporting

confidence: 69%

Atrial Fibrillation Ablation: Aiming to Improve Quantity and Quality of Life

Andrade

Macle

2022

Circulation

Self Cite

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“…The volume of cryoballoon ablation has markedly increased and accounted for 10% of ablation cases in 2020, which was attributed to China's approval of the second-generation cryoballoon, the indication for persistent AF, and positive trial results as the initial treatment option for AF. 19 In comparison, cardioversion has remained at a constant low level, probably due to its burdensome requirements of general anesthesia and ruling out intracardiac thrombus.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology, management, and outcomes of atrial fibrillation among 30 million citizens in Shanghai, China from 2015 to 2020: A medical insurance database study

Liao

et al. 2022

The Lancet Regional Health - Western Pacific

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“…As previous studies have reported, balloon-based ablations not only have equal clinical utility ( 2 , 3 ) but also provide several advantages over traditional surgery, such as a more extensive wide-area ablation ( 4 , 5 ), shorter procedure duration ( 6 ), and less frequent dormant PV conduction ( 7 ). Moreover, compared with antiarrhythmic drug therapy, balloon-based ablations possess the advantage of reducing AF recurrence and improving the patients' quality of life without increasing the incidence of adverse events ( 8 , 9 ). However, the differences in characteristics, effectiveness, safety, and efficacy between HBA and CBA remain undetermined.…”

Section: Introductionmentioning

confidence: 99%

Effects of Hot Balloon vs. Cryoballoon Ablation for Atrial Fibrillation: A Systematic Review, Meta-Analysis, and Meta-Regression

Peng

Liu

Tian

et al. 2021

Front. Cardiovasc. Med.

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Background: Balloon-based catheter ablations, including hot balloon ablation (HBA) and cryoballoon ablation (CBA), have rapidly emerged as alternative modalities to conventional catheter atrial fibrillation (AF) ablation owing to their impressive procedural advantages and better clinical outcomes and safety. However, the differences in characteristics, effectiveness, safety, and efficacy between HBA and CBA remain undetermined. This study compares the characteristic and prognosis differences between HBA and CBA.Methods: Electronic search was conducted in six databases (PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrial.gov, and medRxiv) with specific search strategies. Eligible studies were selected based on specific criteria; all records were identified up to June 1, 2021. The mean difference, odds ratios (ORs), and 95% confidence intervals (CIs) were calculated to evaluate the clinical outcomes. Heterogeneity and risk of bias were assessed using predefined criteria.Results: Seven studies were included in the final meta-analysis. Compared with CBA, more patients in the HBA group had residual conduction and required a higher incidence of touch-up ablation (TUA) [OR (95% CI) = 2.76 (2.02–3.77), P = 0.000]. The most frequent sites of TUA were the left superior pulmonary veins (PVs) in the HBA group vs. the right inferior PVs in the CBA group. During HBA surgery, the left and right superior PVs were more likely to have a higher fluid injection volume. Furthermore, the procedure time was longer in the HBA group than in the CBA group [weighted mean difference (95% CI) = 14.24 (4.39–24.09), P = 0.005]. Patients in the CBA group could have an increased risk of AF occurrence, and accepted more antiarrhythmic drug therapy; however, the result was insignificant.Conclusions: HBA and CBA are practical ablation approaches for AF treatment. Patients who received HBA had a higher incidence of TUA and longer procedure time. Clinical outcomes during the mid-term follow-up between HBA and CBA were comparable.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=259487, identifier: CRD42021259487.

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Cryoballoon Ablation as Initial Treatment for Atrial Fibrillation

Cited by 78 publications

References 57 publications

Atrial Fibrillation Ablation: Aiming to Improve Quantity and Quality of Life

Atrial Fibrillation Ablation: Aiming to Improve Quantity and Quality of Life

Epidemiology, management, and outcomes of atrial fibrillation among 30 million citizens in Shanghai, China from 2015 to 2020: A medical insurance database study

Effects of Hot Balloon vs. Cryoballoon Ablation for Atrial Fibrillation: A Systematic Review, Meta-Analysis, and Meta-Regression

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