German ablation registry: Cryoballoon vs radiofrequency ablation in paroxysmal atrial fibrillation—One-year outcome data

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• 作者：Martin Schmidt ; MD^* ; ^{mschmidtco@arcor.de" class="auth_mail" title="E-mail the corresponding author} ; Uwe Dorwarth ; MD^* ; Dietrich Andresen ; MD^&dagger ; ; Johannes Brachmann ; MD ; FHRS^&Dagger ; ; Karlheinz Kuck ; MD ; FHRS^§ ; ; Malte Kuniss ; MD^¶ ; ; Stephan Willems ; MD^‖ ; Thomas Deneke ; MD ; FHRS^# ; Jü ; rgen Tebbenjohanns ; MD^** ; Jin-Hong Gerds-Li ; MD^&dagger ; &dagger ; ; Stefan Spitzer ; MD ; FHRS^&Dagger ; &Dagger ; ; Jochen Senges ; MD^§ ; § ; ; Matthias Hochadel ; MD^§ ; § ; ; Ellen Hoffmann ; MD^*
• 关键词：Atrial fibrillation ablation ; Registry ; Radiofrequency ablation ; Cryoballoon ; Efficacy ; Safety
• 刊名：Heart Rhythm
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：13
• 期：4
• 页码：836-844
• 全文大小：361 K

文摘

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.

Methods

A total of 2306 patients with symptomatic paroxysmal AF from the German ablation registry were included in this analysis. The cohort was divided into two groups according to the ablation energy source used: cryoballoon and RF ablation. MACCE was defined as a combination of death, myocardial infarction, or stroke.

Results

AF recurrence rate after a single ablation procedure at 1 year follow-up was not significantly different between the two groups (45.8% after cryoablation and 45.4% after RF ablation, P = .87). Also, the rate of patients without AF recurrence and free of antiarrhythmic drug at 12-month follow-up was similar (cryoablation 44.2% and RF 41.4%, P = .25). MACCE occurred with an incidence of 0.7% within 500 days after cryoablation and 1.4% after RF ablation (P = .30). Persistent phrenic nerve palsy was more common after cryoablation compared to RF ablation (1.1% vs 0.3%, P <.05).

Conclusion

AF recurrence rate at 1-year follow-up was similar in RF ablation compared to cryoablation, whereas the spectrum and relevance of complications were significantly different between the two ablation methods. This finding might influence the choice of ablation method offered to the individual paroxysmal AF patient.