P1033Cryo-ablation vs radiofrequency ablation: is there a difference between the two technologies - A single centre analysis of the sites pulmonary vein reconnection

Abstract

Abstract Funding Acknowledgements Nil Introduction Pulmonary vein isolation (PVI) remains the most common initial ablation strategy for management of atrial fibrillation (AF). The two main methods of creating these lesions include cryo-ablation or radiofrequency ablation (RFA). In both methods, gaps in the encircled lesions have the potential to cause recurrences of AF. The aim of this analysis was to determine whether there is a difference in the number of gap lesions when comparing cryoablation to RFA. Methods A retrospective single tertiary centre analysis was performed in 1152 patients who had an AF ablation between January 2015 to June 2019. Patients who required a redo-PVI were included for analysis (n = 155). Demographic (gender, age), clinical (BMI, type of AF, hypertension, DM, left atrial volume) and procedural (PVI method, fluoroscopy time, procedural time) data was collected. For the redo cases, the number of gap lesions by region were analysed by looking at electromechanical maps to determine where the most common gaps occurred for both technologies Results A total of 155 redo procedures (Cryo-RF, n= 46, RF-RF, n = 109) were analysed. There was no statistically significant difference or linear correlation between being obese and number of gaps in the cryo-RF or RF-RF group (R = -0.042, p = 0.351, R = 0.153, p = 0.110 respectively). The total number of gaps in the in the Cryo-RF group = 232 and RF-RF group = 564. There was no significant difference between the two groups (p = 0.963). There was no significant difference or correlation between the use of contact force and the number of gaps in the RFA group (p = 0.644, R = -0.045). Conclusion Each of these PVI technologies have previously been found to be effective in treating AF. Avoiding gaps during PVI remains challenging. This retrospective analysis has demonstrated that overall there is no difference in the number of gap lesions that occur after using either of these current ablation technologies. Cryo-RF vs RF-RF: group comparison CRYO-RF (n = 46) RF-RF (n = 109) P Value Male (%) 28 (60.1) 80 (73) 0.197 Age at 2nd procedure (mean +/- SD) 61.5 +/- 8.9 59.8 +/- 11.6 0.008 Time between procedures (days - mean +/- SD) 497.5 +/- 228.2 1007.7 +/- 924.8 <0.001 Obese (%) 17 (37) 58 (53) 0.073 LA volume (ml/m2 - mean +/- SD) 59.6 +/- 23 57 +/- 26 0.996 Contact force used in index procedure (%) 68 (62) 0.644 Total number of gaps 232 564 0.963 Table representing difference between and significance level for Cryo-RF and RF-RF groups.