Head‐to‐head comparison of acute and chronic pulmonary vein stenosis for cryoballoon versus radiofrequency ablation

Watanabe, Ryoji; Sairaku, Akinori; Yoshida, Yukihiko; Nanasato, Mamoru; Kamiya, Hiroki; Suzuki, Hitoshi; Ogura, Yasuhiro; Aoyama, Yutaka; Maeda, Mayuho; Ando, Motomi; Eguchi, Shunsuke; Inden, Yasuya; Kihara, Yasuki; Murohara, Toyoaki

doi:10.1111/pace.13293

Cited by 14 publications

(16 citation statements)

References 15 publications

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“…Of the initial 752 collected articles, 12 studies were eligible to be included in this systematic review and meta-analysis [42][43][44][45][46][47][48][49][50][51][52][53]. A flowchart describing the study selection process is presented in Figure 1.…”

Section: Study Selection Processmentioning

confidence: 99%

“…Our current systematic review and meta-analysis included one multicenter RCT [42], two single-center RCTs [43,51], six single-center cohort studies [44][45][46][47]50,53], and three multicenter cohort studies [48,49,52]. Electro-anatomical mapping was conducted using CARTO 3 in nine studies [42][43][44][45][46][47][48]51,52]. In three studies, electro-anatomical mapping was performed using CARTO 3 or EnSite [49,50,53].…”

Section: Baseline Characteristicsmentioning

confidence: 99%

“…Only a study from Squara et al [49] used the 23 or 28 mm 2G-CB catheters. However, in other studies, the 28-mm 2G-CB catheter was used to conduct cryoballoon ablation [42][43][44][45][46][47][48][50][51][52][53]. Cryoballoon ablation procedures were conducted one to two times for each pulmonary vein, with durations ranging from 180 to 240 s. Radiofrequency ablation procedures were conducted using the CF-RF catheter [42][43][44][45][46][47][48][49][50][51][52][53].…”

Section: Baseline Characteristicsmentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of the Direct Comparison of Second-Generation Cryoballoon Ablation and Contact Force-Sensing Radiofrequency Ablation in Patients with Paroxysmal Atrial Fibrillation

Waranugraha

Rizal

Yuniadi

2022

JPM

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The superiority of second-generation cryoballoon (2G-CB) ablation versus contact force-sensing radiofrequency (CF-RF) ablation in patients with paroxysmal atrial fibrillation (AF) was assessed in this systematic review and meta-analysis. Freedom from atrial tachyarrhythmias (ATAs) (OR = 0.89; 95% confidence interval [CI] = 0.68 to 1.17; p = 0.41), freedom from AF (OR = 0.93; 95% CI = 0.65 to 1.35; p = 0.72), and acute pulmonary vein isolation (PVI) (OR = 1.17; 95% CI = 0.54 to 2.53; p = 0.70) between 2G-CB ablation and CF-RF ablation were not different. The procedure time for the 2G-CB ablation was shorter (MD = −18.78 min; 95% CI = −27.72 to −9.85 min; p < 0.01), while the fluoroscopy time was similar (MD = 2.66 min; 95% CI = −0.52 to 5.83 min; p = 0.10). In the 2G-CB ablation group, phrenic nerve paralysis was more common (OR = 5.74; 95% CI = 1.80 to 18.31; p = < 0.01). Regarding freedom from ATAs, freedom from AF, and acute PVI, these findings imply that 2G-CB ablation is not superior to CF-RF ablation in paroxysmal AF. Although faster than CF-RF ablation, 2G-CB ablation has a greater risk of phrenic nerve paralysis.

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Section: Study Selection Processmentioning

confidence: 99%

Section: Baseline Characteristicsmentioning

confidence: 99%

Section: Baseline Characteristicsmentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of the Direct Comparison of Second-Generation Cryoballoon Ablation and Contact Force-Sensing Radiofrequency Ablation in Patients with Paroxysmal Atrial Fibrillation

Waranugraha

Rizal

Yuniadi

2022

JPM

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“…The ablation procedures were started in the morning. The details of the double Lasso catheter-guided extensive encircling pulmonary vein antrum isolation performed in this study have been described previously [17]. In brief, 2 decapolar circular catheters were positioned within the ipsilateral superior and inferior pulmonary veins.…”

Section: Ablation Proceduresmentioning

confidence: 99%

Intraprocedural anticoagulation and postprocedural hemoglobin fall in atrial fibrillation ablation with minimally interrupted direct oral anticoagulants: comparisons across 4 drugs

Sairaku

Morishima

Matsumura

et al. 2020

Preprint

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Background: Thromboembolic or hemorrhagic complications related to atrial fibrillation (AF) ablation are rare, and thus, it is difficult to compare their frequency across different direct oral anticoagulants (DOACs). We aimed to compare the intraablation blood coagulability and postprocedural hemoglobin fall as alternatives to those complications across 4 DOACs. Methods: We enrolled AF patients younger than 65 years old in 3 cardiovascular centers who skipped a single dose of apixaban, dabigatran, edoxaban, and rivaroxaban, prior to the ablation. Endpoints included the activated clotting time (ACT), heparin requirement during the ablation, and drop in the hemoglobin level 24 hours after the procedure. Results: The time-course curves of the ACT differed significantly across the patients with apixaban (N=113), dabigatran (N=130), edoxaban (N=144), and rivaroxaban (N=81), with its highest level in the dabigatran group (P <0.001). The average ACT was greater in the dabigatran group than in the other groups (312.3±34, 334.4±44, 308.1±41, and 305.8±34.7 sec; P <0.001). A significant difference was noted in total heparin requirement across the patient groups (3990.2±1167.9, 3890.4±955.3, 4423.8±1051.6, and 3972±978.7 U/m2/h; P <0.001), with its greatest amount in the edoxaban group. The reduction in the hemoglobin level was similar (-0.93±0.92, -0.88±0.79, -0.89±0.97, -0.95±1.23 g/dL; P=0.94). No inter-group difference was noted in the rate of major or minor bleedings (0.9%, 2.3%, 1.4%, and 3.7%; P=0.51), and no thromboembolic events were encountered. Conclusion: A difference in DOACs may have an impact on intraablation anticoagulation, however, it may not on the procedural blood loss in the setting of a single skip.

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“…The ablation procedures were started in the morning. The details of the double Lasso catheter-guided extensive encircling pulmonary vein antrum isolation performed in this study have been described previously [14]. In brief, 2 decapolar circular catheters were positioned within the ipsilateral superior and inferior pulmonary veins.…”

Section: Ablation Proceduresmentioning

confidence: 99%

A smaller post-procedural hemoglobin fall in patients with preexisting anemia undergoing atrial fibrillation ablation with a single skipped dose of direct oral anticoagulants: Another anemia paradox

Sairaku¹,

Morishima²,

Kinoshita³

et al. 2020

Preprint

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Background: There is a concern about worsening of anemia after atrial fibrillation (AF) ablation in anemic patients. We aimed to clarify whether or not patients with anemia who are on an oral anticoagulant therapy are more likely to lose blood after AF ablation. Methods: We studied AF patients in 3 cardiovascular centers who skipped a single dose of direct oral anticoagulants prior to the ablation, and compared the drop in the hemoglobin level 24 hours after the procedure and bleeding complications between the patients with and without preexisting anemia. Results: We identified 183 (15.7%) patients with anemia at baseline out of 1163 patients. The reduction in the hemoglobin level (-0.39±0.71 vs. -0.93±0.9 g/dL; P<0.001) was smaller in the anemic than non-anemic patients. A fall in the hemoglobin level of [?]2 g/dL was less common in anemic patients (1.6% vs. 11.3%; P<0.001). A female gender (odds ratio [OR] 1.62, confidence interval [CI] 1.07-2.45; P=0.02), persistent or longstanding persistent versus paroxysmal AF (OR 1.67, CI 1.13-2.49; P=0.01), ORBIT score [?]3 (OR 3.5, CI 1.34-8.94; P=0.01), and preexisting anemia (OR 0.02, CI 0.004-0.14; P<0.001) were independently associated with the fall in the hemoglobin level of [?]2 g/dL. No difference was noted in the rate of major bleeding complications (1.6% vs. 1.2%; P=0.72). Conclusions: Paradoxically, patients with preexisting anemia may be less likely to lose blood following AF ablation.

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Head‐to‐head comparison of acute and chronic pulmonary vein stenosis for cryoballoon versus radiofrequency ablation

Abstract: CB ablation may reduce the acute narrowing of the left-sided PVs as compared to RF ablation.

Cited by 14 publications

References 15 publications

A Systematic Review and Meta-Analysis of the Direct Comparison of Second-Generation Cryoballoon Ablation and Contact Force-Sensing Radiofrequency Ablation in Patients with Paroxysmal Atrial Fibrillation

A Systematic Review and Meta-Analysis of the Direct Comparison of Second-Generation Cryoballoon Ablation and Contact Force-Sensing Radiofrequency Ablation in Patients with Paroxysmal Atrial Fibrillation

Intraprocedural anticoagulation and postprocedural hemoglobin fall in atrial fibrillation ablation with minimally interrupted direct oral anticoagulants: comparisons across 4 drugs

A smaller post-procedural hemoglobin fall in patients with preexisting anemia undergoing atrial fibrillation ablation with a single skipped dose of direct oral anticoagulants: Another anemia paradox

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