Comparison between radiofrequency with contact force-sensing and second-generation cryoballoon for paroxysmal atrial fibrillation catheter ablation: A multicentre European evaluation

Fabien Squara, Alexandre Zhao, Eloi Marijon, Decebal Gabriel Latcu, Rui Providencia, Giacomo Di Giovanni, Gaël Jauvert, Francois Jourda, Gian Battista Chierchia, Carlo De Asmundis, Giuseppe Ciconte, Christine Alonso, Caroline Grimard, Serge Boveda, Bruno Cauchemez, Nadir Saoudi, Pedro Brugada, Jean Paul Albenque, Olivier Thomas

Research output: Contribution to journalArticle

Abstract

Aims Whether pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) using contact force (CF)-guided radiofrequency (RF) or second-generation cryoballoon (CB) present similar efficacy and safety remains uncertain. Methods and results We performed a multicentre study comparing procedural safety and arrhythmia recurrence after standardized PVI catheter ablation for PAF using CF-guided RF ablation (Thermocool® SmartTouch™, Biosense Webster; or Tacticath™, St Jude Medical) (CF group) with second-generation CB ablation (Arctic Front Advance™, Medtronic) (CB group). Overall, 376 patients (mean age 59.8 ± 10.4 years, 280 males) were enrolled in 4 centres: 198 in CF group and 178 in CB group. Procedure was shorter for CB group than for CF group (109.6 ± 40 vs. 122.5 ± 40.7 min, P = 0.003), but fluoroscopy duration and X-ray exposure were not statistically different (P = 0.1 and P = 0.22, respectively). Overall complication rate was similar in both groups: 14 (7.1%) in the CF group vs. 13 (7.3%) in the CB group (P = 0.93). However, transient right phrenic nerve palsy occurred only in CB group (10 patients, 5.6%; P = 0.001 vs. CF group) and severe non-lethal complications (embolic event, tamponade, or oesophageal injury) occurred only in CF group (5 patients, 2.5%; P = 0.03 vs. CB group). No periprocedural death occurred in either group. Single-procedure freedom from any atrial arrhythmias at 18 months post-ablation was comparable in CF group and CB group (76 vs. 73.3%, respectively, log rank P = 0.63). Conclusion Pulmonary vein isolation using CF-guided RF and second-generation CB leads to comparable single-procedure arrhythmia-free survival at up to 18 months with similar overall complication rate.

Original languageEnglish
Pages (from-to)718-724
Number of pages7
JournalEuropace
Volume17
Issue number5
DOIs
Publication statusPublished - Apr 2 2015

Keywords

  • Ablation
  • Atrial fibrillation
  • Cryoballoon
  • Radiofrequency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

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    Squara, F., Zhao, A., Marijon, E., Latcu, D. G., Providencia, R., Di Giovanni, G., Jauvert, G., Jourda, F., Chierchia, G. B., De Asmundis, C., Ciconte, G., Alonso, C., Grimard, C., Boveda, S., Cauchemez, B., Saoudi, N., Brugada, P., Albenque, J. P., & Thomas, O. (2015). Comparison between radiofrequency with contact force-sensing and second-generation cryoballoon for paroxysmal atrial fibrillation catheter ablation: A multicentre European evaluation. Europace, 17(5), 718-724. https://doi.org/10.1093/europace/euv060