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Published Monthly, in English
Founded: 1919
ISSN 0006-9248
(E)ISSN 1336-0345

Impact factor 1.564

 

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BLL_2023_023

Title: Comparison of second-generation cryoballoon ablation and quantitative radiofrequency ablation guided by ablation index for atrial fibrillation
Author: Qin-Dan YAN, Ke-Zeng GONG, Xue-Hai CHEN, Jian-Hua CHEN, Zhe XU, Wei-Wei WANG, Fei-Long ZHANG

Abstract: BACKGROUND: Radiofrequency ablation and cryoballoon ablation are the main methods of catheter ablation for patients with atrial fibrillation (AF). However, different ablation catheters have different efficacy and complication rates. This study aimed to compare the efficacy and complication rates of quantitative radiofrequency ablation guided by ablation index (RFCA-AI) with those of second-generation cryoballoon ablation (CBA-2).
METHODS: A total of 230 consecutive patients with symptomatic AF undergoing a first ablation procedure of CBA-2 (92 patients) or RFCA-AI (138 patients) were enrolled in this study.
RESULTS: The late recurrence rate in the CBA-2 group was higher than that in the RFCA-AI group (p = 0.012). Subgroup analysis showed the same result in patients with paroxysmal AF (PAF) (p = 0.039), but no difference was found in patients with persistent AF (p = 0.21). The average operation duration in the CBA-2 group (85 (75–99.5) min) was shorter than that in the RFCA-AI group (100 (84.5–120) min), but the average exposure time in the CBA-2 group (17.36 (13.87–22.49) min vs 5.49 (4.00–8.24) min; p < 0.0001) and X-ray dose (223.25 (149.15–336.95) min vs 109.15 (80.75–168.7) min; p < 0.0001) were significantly longer than those in RFCA-AI group. The patients were then divided into a late recurrent group and a late recurrence-free group. Multivariate logistic regression analysis showed that left atrial diameter (LAD), early recurrence, and methods of ablation (cryoballoon ablation) were independent risk factors for late recurrence after AF ablation.
CONCLUSION: For patients with PAF, CBA-2 was inferior to RFCA-AI. Furthermore, although RFCA-AI had an equivalent complication rate and longer operation time than CBA-2, it also had a shorter exposure time and required a lower radiation dose. The early recurrence of AF and LAD were independent risk factors for predicting late recurrence after AF ablation (Tab. 5, Fig. 3, Ref. 29).

Keywords: atrial fibrillation; cryoablation; radiofrequency ablation; second-generation cryoballoon; ablation index
Published online: 03-Jan-2023
Year: , Volume: , Issue: Page From: , Page To:
doi:10.4149/BLL_2023_023


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