Long-term comparison of cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: a propensity score matched analysis

Int J Cardiol. 2014 Oct 20;176(3):645-50. doi: 10.1016/j.ijcard.2014.06.038. Epub 2014 Jul 2.

Abstract

Background: Although radiofrequency (RF) and cryoballoon (CB) based technologies for pulmonary vein isolation (PVI) have both individually been demonstrated to be effective and safe for the treatment of paroxysmal AF, head-to-head comparisons are lacking. The purpose of this study was to compare the outcome of cryoballoon versus radiofrequency ablation in patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation.

Methods: Out of a prospective registry of 327 patients undergoing PVI, 208 patients (age 58±11 years, ejection fraction 59±6%, left atrial size 39±6 mm) with paroxysmal AF were identified. The presented dataset was obtained by 1:1 propensity score matching and contained 142 patients undergoing CB-PVI or RF-PVI in conjunction with a 3D mapping system, respectively. We compared single procedure efficacy of the two methods using a Cox proportional hazards model.

Results: After a mean follow-up of 28 months and a single procedure, AF recurred in 37 of 71 (52%) in the CB-PVI group and in 31 of 71 patients (44%) in the RF-PVI group (HR [95% CI]=1.19 [0.74, 1.92], p=0.48). Recurrence of AF for PVI using solely the CB was observed in 23 of 51 (45%) patients and in 23 of 51 (45%) patients in the corresponding RF-PVI group (HR [95% CI]=0.93 [0.52, 1.66], p=0.81). Complication rate was not different between the groups.

Conclusion: A propensity score matched comparison between CB-PVI and RF-PVI using a 3D-mapping system for AF ablation showed similar long-term success rates.

Keywords: Ablation; Atrial fibrillation; Cryoballoon; Pulmonary vein isolation; Radiofrequency.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrial Fibrillation / surgery*
  • Catheter Ablation / methods*
  • Cryosurgery / methods*
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / epidemiology
  • Propensity Score
  • Prospective Studies
  • Recurrence
  • Registries
  • Switzerland / epidemiology
  • Treatment Outcome