Abstract
Early recurrence (ER) of atrial fibrillation (AF) within 90 days post-ablation is observed in up to 50% of patients and has been attributed to transient inflammation. The importance of ER in current era of pulmonary vein isolation (PVI) with cryoballoon ablation (CBA) and contact-force catheter radiofrequency ablation (cfRFA) has not been clearly reported. In addition, it is not known whether there are differences between types of ablation energy used during PVI. Study population was drawn from a prospective multicenter database of AF ablation. Consecutive patients undergoing first-time ablation with PVI alone, using either second-generation CBA or cfRFA catheters were included. Patients were followed at 0.5, 3, 6, and 12 months to assess recurrence. Predictors of late recurrence (LR), defined as recurrence outside the blanking period, were assessed by Cox proportional hazards regression models. Freedom from LR was calculated and compared between two groups using the Kaplan-Meier method and log-rank test. Study cohort included 300 patients (1:1 CBA:RFA, age 63.6 ± 10.3 years, 67% male). There were no baseline characteristic differences between the CBA and cfRFA groups. ER occurred in 23.3% and 16.7% of patients in the CBA and cfRFA groups, respectively (p = 0.149). One-year freedom from LR was similar for both groups (72.7% CBA vs. 78% cfRFA, p = 0.287). Fifty-two patients (25 CBA and 27 cfRFA) underwent repeat ablation and no difference in durability of PVI was found. ER was the only common independent predictor of LR for either group and for the entire cohort (HR 2.3). In our series of AF ablation using second-generation cryoballoon and contact-force RFA catheters, recurrence in the "blanking period" is seen in 20% and remains predictive of late recurrence irrespective of the energy used.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
More From: Journal of Interventional Cardiac Electrophysiology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.