Comparison of Pulmonary Vein Isolation Using Cryoballoon Versus Conventional Radiofrequency for Paroxysmal Atrial Fibrillation

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• 作者：Giacomo Mugnai ; MD^a ; ^b ; ^{mugnai.giacomo@gmail.com" class="auth_mail} ; Gian-Battista Chierchia ; MD ; PhD^a ; Carlo de Asmundis ; MD ; PhD^a ; Juan Sieira-Moret ; MD^a ; Giulio Conte ; MD^a ; Lucio Capulzini ; MD^a ; Kristel Wauters ; MD^a ; Moises Rodriguez-Mañ ; ero ; MD^a ; Giacomo Di Giovanni ; MD^a ; Giannis Baltogiannis ; MD^a ; Giuseppe Ciconte ; MD^a ; Yukio Saitoh ; MD^a ; Justo Juliá ; MD^a ; Pedro Brugada ; MD ; PhD^a
• 刊名：The American Journal of Cardiology
• 出版年：1 May, 2014
• 年：2014
• 卷：113
• 期：9
• 页码：1509-1513
• 全文大小：206 K

文摘

The aim of this study was to compare the results of pulmonary vein isolation using conventional irrigated radiofrequency (RF) approach versus the cryoballoon (CB) ablation. From January 2008 to December 2011, a total of 426 patients with drug-resistant symptomatic paroxysmal atrial fibrillation underwent pulmonary vein isolation as the index procedure by conventional manual RF or CB ablation at our center. A final population of 396 patients was considered for analysis and divided into 2 groups: conventional RF ablation (n聽= 260) and CB ablation (n聽= 136). At a mean follow-up of 23 卤 13聽months (median 27, range 4 to 68), the success rate for RF ablation group was 57.3% (149 patients) and was 63.2% (86 patients) for cryoablation group (p聽= 0.25). Procedural times were significantly shorter in the cryoablation group (192 卤 49 vs 112 卤 58聽minutes, p <0.000001) but not fluoroscopy times (36 卤 14 vs 31 卤 17聽minutes, p聽= 0.45). No clinical predictors were found to predict atrial fibrillation recurrences. Complication rates were similar in both groups except for phrenic nerve palsy that was uniquely observed in the CB group (8.1%, p <0.00001). All phrenic nerve palsies resolved during follow-up. In conclusion, on a medium-term follow-up, conventional point-by-point RF ablation and CB ablation showed similar success rates. Procedural times were significantly shorter in the CB approach. The most frequent complication during CB procedures was phrenic nerve palsy, which occurred in 8.1% of patients and resolved in all during the follow-up period.