Long‐term outcomes of a time to isolation – based strategy for cryoballoon ablation compared to radiofrequency ablation in patients with symptomatic paroxysmal atrial fibrillation

医学 心房颤动 肺静脉 射频消融术 烧蚀 加药 导管消融 临床终点 外科 阵发性心房颤动 内科学 耐火材料(行星科学) 并发症 心脏病学 随机对照试验 物理 天体生物学
作者
Wei Yue,Chen Lin,Jiang Cao,Shaowen Liu,Tianyou Ling,Xinmiao Huang,Genqing Zhou,Changjian Lin,Yun Xie,Yangyang Bao,Qingzhi Luo,Jiawen Ye,Ning Zhang,Qi Jin,Liqun Wu
出处
期刊:Pacing and Clinical Electrophysiology [Wiley]
卷期号:45 (9): 1015-1023 被引量:3
标识
DOI:10.1111/pace.14556
摘要

Abstract Background Cryoballoon ablation (CBA) is one of the most commonly used technologies designed for pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF), although the dosing of CBA remains controversial. We evaluated the long‐term efficacy and safety of a novel individualized strategy of CBA compared to radiofrequency ablation (RFA) for patients with PAF. Methods In this observational study, symptomatic patients with drug‐refractory paroxysmal AF were prospectively consented and enrolled in four centers, being assigned either to the CBA or RFA arm for ablation. In the CBA group, we used a time to isolation (TTI) – based dosing protocol. The primary endpoint was the recurrence of atrial arrhythmia >30 s following a 90‐day blanking period. The secondary endpoint was procedure‐related complications and procedure parameters. Results A total of 500 patients were recruited in either the CBA group ( n = 247) or the RFA group ( n = 253) between January 2017 and July 2018. After a median follow‐up of 778 days, the atrial tachyarrhythmia‐free survival was 71.7% in the CBA group and 67.0% in the RFA group. CBA and RFA displayed similar major or minor complication occurrence, while the former had a significantly shorter procedure duration (82.5 min vs. 141.1 min, p < .001) and left atrial dwell time (60.1 min vs. 109.9 min, p < .001) but longer fluoroscopy exposure (13.8 min vs. 8.1 min, p < .001). Conclusion Compared to RFA, our TTI‐based CBA dosing protocol showed comparable efficacy and safety, with a significantly reduced procedure duration in patients with PAF.
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