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cryoablation vs radiofrequency ablation atrial fibrillation

Mario Matta, Matteo Anselmino, Federico Ferraris, Marco Scaglione, Fiorenzo Gaita
BACKGROUND: Radiofrequency and cryoballoon pulmonary vein isolation are common approaches for paroxysmal atrial fibrillation treatment, showing similar results in recent multicenter studies, including heterogeneous tools and protocols. The aim of this study is to compare prospectively in a single, high-volume center the outcome of paroxysmal atrial fibrillation ablation performed specifically by second-generation cryoballoon or contact force radiofrequency ablation. METHODS: Consecutive patients scheduled for paroxysmal atrial fibrillation transcatheter ablation have been included and prospectively followed up...
April 2018: Journal of Cardiovascular Medicine
Faraz Khan Luni, Abdur Rahman Khan, Hemindermeet Singh, Haris Riaz, Sonia Ali Malik, Owais Khawaja, Talha Farid, Jennifer Cummings, Mohammed Taleb
BACKGROUND: Ablation is used for treatment of atrial fibrillation (AF) but recurrence is common. Dormant conduction is hypothesized to be responsible for these recurrences, and the role of adenosine in identification and ablation of these pathways is controversial with conflicting results on AF recurrence. MATERIALS AND METHODS: We conducted a meta-analysis for studies evaluating AF ablation and adenosine use. Included in the meta-analysis were human studies that compared ablation using adenosine or adenosine triphosphate (ATP) and reported freedom from AF in patients beyond a minimum follow-up of 6 months...
January 2018: American Journal of the Medical Sciences
Alex J A McLellan, Saurabh Kumar, Catherine Smith, Liang-Han Ling, Sandeep Prabhu, Jonathan M Kalman, Peter M Kistler
AIMS: Adenosine may unmask dormant PV conduction and facilitate consolidation of PV isolation. We performed a meta-analysis to determine the impact of adenosine administration on clinical outcomes in patients undergoing PVI. METHODS: References and electronic databases reporting AF ablation and adenosine following PVI were searched through to 22nd November 2015. The impact of adenosine on freedom from AF was assessed in twenty publications after radiofrequency ablation (RFA), and in four publications after cryoablation to achieve PVI...
June 1, 2017: International Journal of Cardiology
Yi-He Chen, Zhao-Yang Lu, Yin- Xiang, Jian-Wen Hou, Qian Wang, Hui Lin, Yi-Gang Li
Aims: Cryoablation is a promising alternative technique to RF ablation for treating paroxysmal AF with encouraging results. However, data about the efficacy and safety comparison between cryoablation and RF ablation is still lacking. Methods and results: We systematically search the PubMed, the Cochrane Library, MEDLINE and Google Scholar databases, and finally identify 16 eligible studies including 7195 patients (2863 for cryoablation; 4332 for RF ablation). Freedom from AF/atrial tachycardial replase is slightly higher in cryoablation than RF ablation during a median 12 months of follow-up, with no statistical significant (RR: 1...
May 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Benjamin Berte, Frédéric Sacher, Jean-Yves Wielandts, Saagar Mahida, Xavier Pillois, Rukshen Weerasooriya, Olivier Bernus, Pierre Jaïs
Introduction: Lack of transmural lesion formation during radiofrequency (RF) ablation for ventricular tachycardia (VT) is an important determinant of arrhythmia recurrence. The aim of this proof-of-concept study was to evaluate safety and efficacy of a new and more powerful cryoablation system for ventricular ablation. Methods and results: Five healthy female sheep (59 ± 6 kg) underwent a surgical sternotomy for epicardial and endocardial access [endocardial access via right atrial appendage and left ventricular (LV) apex]...
August 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Melanie A Gunawardene, Boris A Hoffmann, Benjamin Schaeffer, Da-Un Chung, Julia Moser, Ruken Oezge Akbulak, Mario Jularic, Christian Eickholt, Jana Nuehrich, Christian Meyer, Stephan Willems
Introduction: Comparative data of early recurrence rates of atrial fibrillation (ERAF) following second-generation cryoballoon (CB-G2) and radiofrequency current (RFC) ablation for pulmonary vein isolation (PVI) in paroxysmal AF (PAF) are rare. We randomized PAF patients into either PVI with CB-G2 (group 1) or PVI with a combined RFC-approach applying contact force (CF) with the endpoint of unexcitability (group 2) to investigate ERAF. Methods and results: In group 1 (n = 30), CB-G2-PVI was performed...
January 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Bor Antolič, Andrej Pernat, Marta Cvijić, David Žižek, Matevž Jan, Matjaž Šinkovec
BACKGROUND: Evidence from animal and human studies suggests that cryoablation might be associated with a lesser inflammatory response and activation of coagulation compared with radiofrequency ablation. The study was aimed at comparing the effect of cryoballoon and radiofrequency catheter ablation of paroxysmal atrial fibrillation on markers of myocardial damage, inflammation, and activation of coagulation. METHODS: Forty-one patients received either cryoballoon (n = 23) or radiofrequency (n = 18) ablation of atrial fibrillation...
July 2016: Wiener Klinische Wochenschrift
Rui Providencia, Pascal Defaye, Pier D Lambiase, Dominique Pavin, Jean-Pierre Cebron, Franck Halimi, Frédéric Anselme, Neil Srinivasan, Jean-Paul Albenque, Serge Boveda
AIM: Cryoballoon ablation (Cryoballoon) has emerged as a new alternative for the treatment of symptomatic drug-refractory atrial fibrillation (AF). Whether the results of Cryoballoon are more reproducible than those of radiofrequency (RF) ablation remains to be proved. METHODS AND RESULTS: A total of 860 consecutive patients undergoing a first ablation procedure for paroxysmal AF (467 treated with RF and 393 treated with Cryoballoon) were selected from a prospective multicentre survey of AF ablation (FrenchAF)...
January 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Tina D Hunter, Swetha R Palli, John A Rizzo
OBJECTIVE: The objective of this study was to compare the cost of radiofrequency (RF) ablation vs cryoablation (Cryo) for atrial fibrillation (AF). METHODS: This retrospective cohort study used 2013-2014 records from the Premier Healthcare Database for adults with AF catheter ablation. Exclusions included non-AF ablation, surgical ablation, valve replacement or repair, or cardiac implant. Hospitals were required to perform ≥20 procedures using each technology, with the technology identifiable in at least 90% of cases...
October 2016: Journal of Medical Economics
Tuan Nguyen, Umjeet Jolly, Kiran Sidhu, Raymond Yee, Peter Leong-Sit
Atrial fibrillation (AF) is an increasing global issue leading to increased hospitalizations, adverse health related events and mortality. This review focuses on the management of atrial fibrillation, in particular in the past decade, comparing two major strategies, rate or rhythm control. We evaluate the evidence for each strategy, pharmacological options and the increasing utilization of invasive techniques, in particular catheter ablation and use of implantable cardiac pacing devices. Pharmacological comparative trials evaluating both strategies have shown rate control being non-inferior to rhythm control for clinical outcomes of mortality and other cardiovascular events (including stroke)...
June 2016: Expert Review of Cardiovascular Therapy
Philipp Attanasio, Martin Huemer, Abdul Shokor Parwani, Leif-Hendrik Boldt, Andreas Mügge, Wilhelm Haverkamp, Alexander Wutzler
BACKGROUND: Left atrial ablation can be accompanied by discomfort or pain. The purpose of this study was to systematically compare pain reactions during ablation of atrial fibrillation under deep sedation with cryothermal and radiofrequency energy. METHODS AND RESULTS: Circumferential ablation was performed in patients with atrial fibrillation using either radiofrequency (RF) or cryoenergy. Deep sedation was achieved with a combination of propofol and midazolam...
May 2016: Pacing and Clinical Electrophysiology: PACE
Z Khoueiry, J-P Albenque, R Providencia, S Combes, N Combes, F Jourda, P A Sousa, C Cardin, J-L Pasquie, T T Cung, F Massin, E Marijon, S Boveda
AIMS: Pulmonary vein isolation is the mainstay of treatment in catheter ablation of paroxysmal atrial fibrillation (AF). Cryoballoon ablation has been introduced more recently than radiofrequency ablation, the standard technique in most centres. Pulmonary veins frequently display anatomical variants, which may compromise the results of cryoballoon ablation. We aimed to evaluate the mid-term outcomes of cryoballoon ablation in an unselected population with paroxysmal AF from an anatomical viewpoint...
September 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Martin Schmidt, Uwe Dorwarth, Dietrich Andresen, Johannes Brachmann, Karlheinz Kuck, Malte Kuniss, Stephan Willems, Thomas Deneke, Jürgen Tebbenjohanns, Jin-Hong Gerds-Li, Stefan Spitzer, Jochen Senges, Matthias Hochadel, Ellen Hoffmann
BACKGROUND: Although radiofrequency (RF) ablation has long been the standard of care for atrial fibrillation (AF) ablation, cryoballoon technology has emerged as a feasible approach with promising results. Prospective multicenter registry data referring to both ablation technologies in AF ablation are lacking so far. OBJECTIVE: The purpose of this study was to report data from the German ablation registry with respect to efficacy and safety in pulmonary vein ablation with different energy sources for paroxysmal AF after 1-year follow-up...
April 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Niv Ad, Sari D Holmes, Deborah J Shuman, Graciela Pritchard
BACKGROUND: Atrial fibrillation (AF) duration is one of the most consistent predictors of Cox maze (CM) procedure failure. We examined the impact of AF duration on CM success in patients having first-time concomitant surgery. METHODS: First-time concomitant CM was performed in 505 patients. Freedom from atrial arrhythmia (AA) and class I/III antiarrhythmic drug (AAD) data were collected prospectively. Patients with longer AF duration (≥ 5 years; n = 113) were compared with shorter duration (<5 years; n = 392) in primary analyses...
November 2015: Annals of Thoracic Surgery
Kevin Phan, Ashleigh Xie, Narendra Kumar, Sophia Wong, Caroline Medi, Mark La Meir, Tristan D Yan
Simplified maze procedures involving radiofrequency, cryoenergy and microwave energy sources have been increasingly utilized for surgical treatment of atrial fibrillation as an alternative to the traditional cut-and-sew approach. In the absence of direct comparisons, a Bayesian network meta-analysis is another alternative to assess the relative effect of different treatments, using indirect evidence. A Bayesian meta-analysis of indirect evidence was performed using 16 published randomized trials identified from 6 databases...
August 2015: European Journal of Cardio-thoracic Surgery
J Brian DeVille, J Thomas Svinarich, Dan Dan, Andrew Wickliffe, Charan Kantipudi, Hae W Lim, Lisa Plummer, James Baker, Marcin Kowalski, Hassan Baydoun, Mark Jenkins, Peter Chang-Sing
BACKGROUND: Point-to-point focal radiofrequency (RF) catheter ablation for aberrant pulmonary vein triggers that manifest into atrial fibrillation (AF) is the traditional method for treating symptomatic drug-resistant paroxysmal AF (PAF) when an ablation procedure is warranted. More recently, pulmonary vein isolation (PVI) using the cryoballoon has been demonstrated to be safe and effective (STOP AF clinical trial). Currently, two small studies have reviewed the procedural efficiency when comparing cryoballoon to focal RF catheter ablation procedures; however, no multicenter study has yet reported on this comparison of the two types of ablation catheters...
June 2014: Journal of Invasive Cardiology
Giacomo Mugnai, Gian-Battista Chierchia, Carlo de Asmundis, Juan Sieira-Moret, Giulio Conte, Lucio Capulzini, Kristel Wauters, Moises Rodriguez-Mañero, Giacomo Di Giovanni, Giannis Baltogiannis, Giuseppe Ciconte, Yukio Saitoh, Justo Juliá, Pedro Brugada
The aim of this study was to compare the results of pulmonary vein isolation using conventional irrigated radiofrequency (RF) approach versus the cryoballoon (CB) ablation. From January 2008 to December 2011, a total of 426 patients with drug-resistant symptomatic paroxysmal atrial fibrillation underwent pulmonary vein isolation as the index procedure by conventional manual RF or CB ablation at our center. A final population of 396 patients was considered for analysis and divided into 2 groups: conventional RF ablation (n = 260) and CB ablation (n = 136)...
May 1, 2014: American Journal of Cardiology
Martin Schmidt, Uwe Dorwarth, Dietrich Andresen, Johannes Brachmann, Karl-Heinz Kuck, Malte Kuniss, Thorsten Lewalter, Stefan Spitzer, Stephan Willems, Jochen Senges, Claus Jünger, Ellen Hoffmann
BACKGROUND: Catheter ablation is used extensively with curative intention in atrial fibrillation. Radiofrequency ablation has long been a standard of care, while cryoballoon technology has emerged as a feasible approach with promising results. Prospective multicenter registry data referring to both ablation technologies in AF ablation therapy are lacking. METHODS: Between January 2007 and August 2011, a total of 3,775 consecutive patients with symptomatic paroxysmal AF who underwent PV ablation in their respective centers were enrolled...
January 2014: Journal of Cardiovascular Electrophysiology
Nicasio Pérez-Castellano, Roberto Fernández-Cavazos, Javier Moreno, Victoria Cañadas, Asunción Conde, Juan J González-Ferrer, Carlos Macaya, Julián Pérez-Villacastín
BACKGROUND: Results from randomized trials designed to compare cryoenergy with radiofrequency for pulmonary vein (PV) isolation are lacking. OBJECTIVE: To compare the efficacy of a simplified strategy for PV cryoablation (group C) vs PV isolation with open-irrigated radiofrequency catheters (group R). METHODS: Fifty patients with paroxysmal atrial fibrillation (AF) and 4 independent PVs received a Reveal XT implantable cardiac monitor and were randomized to group C or group R...
January 2014: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Jeffrey Mandell, Frank Amico, Sameer Parekh, Jeffrey Snow, Joseph Germano, Todd J Cohen
BACKGROUND: Radiofrequency (RF) catheter ablation has provided an effective method for treating drug-refractory symptomatic atrial fibrillation. Recently, a cryoablation balloon approach has also received approval. The purpose of this study was to compare RF catheter ablation to cryoablation for the treatment of atrial fibrillation with respect to safety, immediate efficacy, and effects on procedural and fluoroscopy times. In addition, actual procedural costs were compared. METHODS: This study was approved by the Winthrop University Hospital Institutional Review Board to retrospectively examine cryoablation with the Arctic Front Cardiac CryoAblation balloon catheter (Medtronic, Inc) and compare it to RF catheter ablation for the treatment of drug-refractory symptomatic atrial fibrillation...
June 2013: Journal of Invasive Cardiology
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