Sex‐specific efficacy and safety of cryoballoon versus radiofrequency ablation for atrial fibrillation: A systematic review and meta‐analysis

Lavallaz, Jeanne du Fay de; Clerc, Olivier; Pudenz, Christiane; Illigens, Ben; Kühne, Michael

doi:10.1111/jce.14071

Cited by 6 publications

(4 citation statements)

References 56 publications

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“…The procedure and ablation time was longer than in some previous studies of RF or cryoablation [De Lavallaz 2019;Calkins 2012;Chen 2017], but they were similar to the average times observed in previous observational studies of catheter ablation [Wechselberger 2018]. The study protocol components, in particular the 30-minute evaluation period at the end, also contributed to an increase of the procedure duration [Tuleutayev 2017].…”

Section: Discussionsupporting

confidence: 73%

Efficacy and Safety Results of Different Ablation Technologies for Persistent Atrial Fibrillation Treatment

Baimbetov

Bizhanov

Yakupova

et al. 2022

HSF

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Introduction: Pulmonary vein isolation is the primary goal in treating patients with paroxysmal atrial fibrillation using catheter ablation. This study's purpose is a comparative assessment of the efficacy and safety of two strategies for catheter treatment in patients with persistent atrial fibrillation. Patients and methods: The study included 127 patients with persistent atrial fibrillation during the last six months before inclusion in the study. The average follow-up period was 24 months. Results: The primary efficacy endpoint (death, cerebrovascular event, or serious complications associated with treatment) occurred in 15 patients in the cryoballoon ablation group and 14 patients in the radiofrequency ablation group. The Kaplan-Meier survival estimates were 30% and 28%, and the risk ratio 0.96 and 95% of the confidence interval. Conclusions: The treatment in patients with persistent atria fibrillation, using catheter ablation with contact force control catheter treatment with the pulmonary vein isolation, was more efficient.

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Section: Discussionsupporting

confidence: 73%

Efficacy and Safety Results of Different Ablation Technologies for Persistent Atrial Fibrillation Treatment

Baimbetov

Bizhanov

Yakupova

et al. 2022

HSF

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“…Safety is of utmost importance when introducing a novel technology, and CB ablation has been shown to be associated with a low peri-procedural complication rate based on data with the SCB [ 4 , 5 , 15 , 16 ]. Both in our series and the first report on ablation using the NCB, there was one stroke or transient ischemic attack.…”

Section: Discussionmentioning

confidence: 99%

Technical and procedural comparison of two different cryoballoon ablation systems in patients with atrial fibrillation

Knecht

Sticherling

Roten

et al. 2021

J Interv Card Electrophysiol

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Purpose The aim was to report procedural and technical differences of a novel cryoballoon (NCB) ablation catheter for pulmonary vein isolation (PVI) compared to the standard cryoballoon (SCB) catheter. Methods Consecutive patients with atrial fibrillation (AF) undergoing PVI using the NCB and the SCB were included. Procedural parameters, technical differences, acute efficacy, and safety are reported. Results Eighty patients (age 66 ± 10 years, ejection fraction 57 ± 10%, left atrial volume index 40 ± 6 ml/m2) were studied. With the NCB, 156 of 158 PVs (99%) were isolated compared to isolation of 159 of 159 PVs (100%) with the SCB. The median number of freezes in the NCB and the SCB group was 6 (IQR 5–8) and 5 (IQR 4–7), respectively (p = 0.051), with 73% and 71% of the PVs isolated with a single freeze, respectively. Nadir temperature and temperature at isolation were − 59 ± 6 °C and − 45 ± 17 °C in the NCB group and − 46 ± 7 °C and − 32 ± 23 °C in the SCB group, respectively (both p < 0.001) with no difference in time to isolation (TTI). Procedural differences were observed for the total procedure time (84 ± 29 min in the NCB group and 65 ± 17 min in the SCB group, p = 0.003). There was a peri-procedural stroke in one patient in the NCB group. Differences in catheter design were observed that may account for the differences in temperature recordings and ice cap formation. Conclusions Acute efficacy and TTI were similar with the NCB compared to the SCB. Measured temperatures were lower with the NCB, most likely due to differences in catheter design.

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“…This finding is in contrast with those of other studies that demonstrated that female sex may be the largest predictor of AF recurrence following PVI. 39 This outcome should be considered with the knowledge that, usually, most studies still do not include assessments of comparative sex-specific efficacy, safety, and procedural characteristics due to the unequal and low enrollment numbers of women. 40 This series had a relatively higher percentage of women, with 47% in the FLUORO group and 39% in the SANS FLUORO group; the comparatively increased female-to-male ratio may have contributed to the similar efficacy findings.…”

Section: Discussionmentioning

confidence: 99%

The Grand SANS FLUORO (SAy No Series to FLUOROsopy) Study: Examining Fluoroscopy Use in More than 1,000 Ablation Procedures

Percell¹,

Pike²,

Olmsted³

et al. 2020

J Innov Cardiac Rhythm Manage.

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The majority of electrophysiologists routinely use fluoroscopy (FLUORO) during ablation procedures for common arrhythmias despite the known complications of radiation exposure and protective lead use. This study assessed the safety of catheter ablation (CA) with FLUORO versus without FLUORO (SANS FLUORO) in patients with the following common arrhythmias: atrial fibrillation (AF), atrial flutter, supraventricular tachycardia, and ventricular tachycardia. A total of 1,258 CA procedures were performed in 816 consecutive patients over a 53-month period (SANS FLUORO CA: 609 patients; FLUORO CA: 209 patients). The secondary outcome was the efficacy of AF ablation in FLUORO versus SANS FLUORO patients. Ultimately, there was no statistically significant difference found concerning the safety of CA in the SANS FLUORO and FLUORO groups in terms of procedure time, vascular complications, tamponade, stroke, or death. FLUORO patients had markedly increased FLUORO time, increased radiation exposure, and increased dose-area product (all p < 0.0001). AF development after SANS FLUORO CA of AF was not different from that after FLUORO CA regardless of the pulmonary vein isolation (PVI) modality used (cryoablation versus radiofrequency) at 24 months (p = 0.21). Additionally, women fared just as well as men after CA ablation for AF. At 36 months, 58% of SANS FLUORO AF device patients were free from AF. As such, SANS FLUORO CA of common arrhythmias appears to be as safe as FLUORO CA but with a markedly reduced level of radiation exposure. Also, SANS FLUORO CA remains as effective as FLUORO CA in the prevention of AF for up to 24 months.

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Sex‐specific efficacy and safety of cryoballoon versus radiofrequency ablation for atrial fibrillation: A systematic review and meta‐analysis

Cited by 6 publications

References 56 publications

Efficacy and Safety Results of Different Ablation Technologies for Persistent Atrial Fibrillation Treatment

Efficacy and Safety Results of Different Ablation Technologies for Persistent Atrial Fibrillation Treatment

Technical and procedural comparison of two different cryoballoon ablation systems in patients with atrial fibrillation

The Grand SANS FLUORO (SAy No Series to FLUOROsopy) Study: Examining Fluoroscopy Use in More than 1,000 Ablation Procedures

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