PO-02-038 LESION SIZE PREDICTION MODULE-GUIDED RADIOFREQUENCY ABLATION VERSUS CRYOBALLOON ABLATION FOR PAROXYSMAL ATRIAL FIBRILLATION: A PROPENSITY SCORE MATCHED ANALYSIS

Abstract

In previous studies show cryoballoon ablation (CBA) and radiofrequency ablation (RFA) are similar results. However, RFA technology has progressed in few years, lesion size assessment module developed to improve lesion durability. The aim of this study was to compare clinical outcome of RFA guided by lesion size prediction module and second or fourth-generation CBA in patients with paroxysmal atrial fibrillation (PAF). We enrolled 1905 patients with PAF (65.2 ± 11.3years, male 68.0%). 205 patients after RFA who underwent ablation guided by lesion size prediction module, Ablation Index or Lesion Size Index, and 1700 patients after second or fourth-generation CBA in September 2014 to August 2020, and evaluated retrospectively. We performed pulmonary vein isolation with CBA or RFA followed by additional non-pulmonary vein foci ablation. We selected 194 patients treated with RFA (follow-up period 14.1 ± 7.9months) and 194 patients treated with CBA (follow-up period 23.9 ± 12.9months) using propensity score matching. During a follow-up period, atrial tachyarrhythmia recurrence was documented in 34 patients (17.5%) in RFA and 38 patients (19.6%) in CBA. Freedom from atrial tachyarrhythmia recurrence without anti-arrhythmic-drugs after single procedure was a similar in 2 groups (1-year Kaplan–Meier survival rate estimates, RFA:84.9% and CBA:88.9%, p=0.358). The mean total procedure time was shorter in CBA than in RFA (109 ± 45 vs 148 ± 54 minutes, P<0.001), and the mean total fluoroscopy time was shorter in RFA than in CBA (20 ± 18 vs 33 ± 21 minutes, P<0.001). The proportion of non-pulmonary vein foci was slightly higher for CBA (42patients, 21.7%) than for RFA (36patients, 18.6%), but this difference was not significant (P=0.447). Similarly, there was no significant difference in ablation of non-pulmonary vein foci in the left atrium, although CBA was slightly more common (CBA: 16 patients, 8.3% and RFA: 10 patients 5.2%, p=0.223). [image] And, A second procedure was treated to 20 patients in the RFA and 32 in the CBA. The number of people with pulmonary vein reconnection in each was 10 patients (50.0%) in RFA and 15 patients (46.9%) in CBA, respectively, with no difference as a percentage(P=0.83). We found that in the treatment of patients with PAF, lesion size prediction module-guided procedure was not statistically significant efficacy to CBA. CBA and RFA are still similar results even today.