Outcomes after cryoablation vs. radiofrequency in patients with paroxysmal atrial fibrillation: impact of pulmonary veins anatomy

Abstract

Our findings suggest that mid-term outcomes of cryoballoon ablation for paroxysmal AF ablation are similar to those of radiofrequency, regardless of PV anatomy. The presence of anatomical variants of PVs should not discourage the referral of patients with paroxysmal AF for cryoballoon ablation.

Hope or Hype – Does Cryoballoon Simplify Atrial Fibrillation Ablation Technique or Just Another Costly Toy? –

“…These study results are consistent with the outcomes reported in other global trials of the effectiveness of cryoballoon. [8][9][10][11][12] Although this study was a PMS, the safety outcome seems not a significant problem with new cryoballoon users.…”

“…Most of the studies demonstrated a similar efficacy between cryoablation and irrigated-tip RF ablation for paroxysmal AF. [8][9][10][11][12] In most studies, procedural duration was shorter and fluoroscopic exposure a little longer than with conventional RF ablation with 3D mapping system. Nevertheless, efficacy is not the only issue we need to consider; safety is also paramount before making this ablation technique available to most operators, including less experienced doctors.…”

“…For example, phrenic nerve paralysis, which occurred in 5-10% of patients after cryoablation, although most cases were transient and asymptomatic. [8][9][10][11][12] There are also concerns of collateral damage to neighboring soft tissues, including the esophagus or bronchus. How to adjust for adequate energy and freezing duration in order to avoid these complications or collateral damage is still unclear and whether a bonus lesion is required after acute PV adiofrequency (RF) energy for catheter ablation of atrial fibrillation (AF) has been a therapeutic option since the reports from Haïssaguerre et al 1 and Chen et al 2 Electrical isolation of the pulmonary veins (PVs) is the cornerstone and established endpoint of AF ablation.…”

Impact of pulmonary vein ostia anatomy on efficacy of cryoballoon ablation for atrial fibrillation

“…Due to the fact that the size and shape of the balloon are predefined, PV anatomy, including number of veins, presence of common trunk, angulation, ostium area and ovality, may have an impact on CB ablation efficacy. A few studies which addressed this issue provided inconsistent results [2][3][4][5][6] . Therefore, the aim of our study was to examine whether PV ostia anatomy is related to the acute and long-term effects of CB of AF.…”

Ablacja napadowego migotania przedsionków opornego na farmakoterapię — przegląd piśmiennictwa dotyczący porównania skuteczności i bezpieczeństwa współcześnie dostępnych technik

“…Wybór techniki ablacyjnej powinien zatem być oparty na lokalnej dostępności danej metody, analizie kosztów procedury, jak również preferencjach oraz doświadczeniu danego ośrodka w konkretnej technice ablacji AF. Krótsza krzywa uczenia i bardziej jednorodne wyniki niezależnie od indywidualnej anatomii ujść żył płucnych [8], jak również mniejsza pracochłonność zabiegu stanowią silne strony techniki krioablacyjnej.…”