Pulsed-field vs. cryoballoon vs. radiofrequency ablation : a propensity score matched comparison of one-year outcomes after pulmonary vein isolation in patients with paroxysmal atrial fibrillation
© 2023. The Author(s)..
BACKGROUND: Pulsed-field ablation (PFA) has shown favourable data in terms of safety and procedural efficiency for pulmonary vein isolation (PVI). We sought to compare procedural and 1-year follow-up data of patients with paroxysmal atrial fibrillation (AF) undergoing PVI using PFA, cryoballoon ablation (CBA) and radiofrequency ablation (RFA).
METHODS: Consecutive patients with paroxysmal AF undergoing a first PVI with PFA at our institution were included. For comparison, patients with paroxysmal AF undergoing a first PVI with CBA and RFA were selected using a 1:2:2 propensity score matching. The PFA group followed the standard 32-applications lesion-set protocol, the CBA group a time-to-effect plus 2-min strategy, and the RFA group the CLOSE protocol. Patients were followed with 7d-Holter ECGs 3, 6, and 12 months after ablation. The primary endpoint was recurrence of atrial tachyarrhythmia (ATa) following a blanking period of 3 months.
RESULTS: A total of 200 patients were included (PFA n = 40; CBA n = 80; RFA n = 80). Median procedure times were shortest with CBA (75 min) followed by PFA (94 min) and RFA (182 min; p < 0.001). Fluoroscopy dose was lowest with RFA (1.6Gycm2) followed by PFA (5.0Gycm2) and CBA (5.7Gycm2; p < 0.001). After a 1-year follow-up, freedom from ATa recurrence was 85.0% with PFA, 66.2% with CBA and 73.8% with RFA (p = 0.12 PFA vs. CBA; p = 0.27 PFA vs. RFA).
CONCLUSION: In a propensity score matched analysis of patients with paroxysmal AF, freedom from any ATa 1 year after PVI using PFA was favourable and at least as good as for PVI with CBA or RFA.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:67 |
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| Enthalten in: |
Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing - 67(2024), 2 vom: 01. März, Seite 389-397 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Maurhofer, Jens [VerfasserIn] |
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| Links: |
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| Themen: |
Cryoballoon ablation |
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| Anmerkungen: |
Date Completed 01.03.2024 Date Revised 02.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10840-023-01651-4 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM36272282X |
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| 100 | 1 | |a Maurhofer, Jens |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pulsed-field vs. cryoballoon vs. radiofrequency ablation |b a propensity score matched comparison of one-year outcomes after pulmonary vein isolation in patients with paroxysmal atrial fibrillation |
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| 500 | |a Date Completed 01.03.2024 | ||
| 500 | |a Date Revised 02.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: Pulsed-field ablation (PFA) has shown favourable data in terms of safety and procedural efficiency for pulmonary vein isolation (PVI). We sought to compare procedural and 1-year follow-up data of patients with paroxysmal atrial fibrillation (AF) undergoing PVI using PFA, cryoballoon ablation (CBA) and radiofrequency ablation (RFA) | ||
| 520 | |a METHODS: Consecutive patients with paroxysmal AF undergoing a first PVI with PFA at our institution were included. For comparison, patients with paroxysmal AF undergoing a first PVI with CBA and RFA were selected using a 1:2:2 propensity score matching. The PFA group followed the standard 32-applications lesion-set protocol, the CBA group a time-to-effect plus 2-min strategy, and the RFA group the CLOSE protocol. Patients were followed with 7d-Holter ECGs 3, 6, and 12 months after ablation. The primary endpoint was recurrence of atrial tachyarrhythmia (ATa) following a blanking period of 3 months | ||
| 520 | |a RESULTS: A total of 200 patients were included (PFA n = 40; CBA n = 80; RFA n = 80). Median procedure times were shortest with CBA (75 min) followed by PFA (94 min) and RFA (182 min; p < 0.001). Fluoroscopy dose was lowest with RFA (1.6Gycm2) followed by PFA (5.0Gycm2) and CBA (5.7Gycm2; p < 0.001). After a 1-year follow-up, freedom from ATa recurrence was 85.0% with PFA, 66.2% with CBA and 73.8% with RFA (p = 0.12 PFA vs. CBA; p = 0.27 PFA vs. RFA) | ||
| 520 | |a CONCLUSION: In a propensity score matched analysis of patients with paroxysmal AF, freedom from any ATa 1 year after PVI using PFA was favourable and at least as good as for PVI with CBA or RFA | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cryoballoon ablation | |
| 650 | 4 | |a Paroxysmal atrial fibrillation | |
| 650 | 4 | |a Pulmonary vein isolation | |
| 650 | 4 | |a Pulsed-field ablation | |
| 650 | 4 | |a Radiofrequency ablation | |
| 700 | 1 | |a Kueffer, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Madaffari, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Stettler, Robin |e verfasserin |4 aut | |
| 700 | 1 | |a Stefanova, Anita |e verfasserin |4 aut | |
| 700 | 1 | |a Seiler, Jens |e verfasserin |4 aut | |
| 700 | 1 | |a Thalmann, Gregor |e verfasserin |4 aut | |
| 700 | 1 | |a Kozhuharov, Nikola |e verfasserin |4 aut | |
| 700 | 1 | |a Galuszka, Oskar |e verfasserin |4 aut | |
| 700 | 1 | |a Servatius, Helge |e verfasserin |4 aut | |
| 700 | 1 | |a Haeberlin, Andreas |e verfasserin |4 aut | |
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| 700 | 1 | |a Tanner, Hildegard |e verfasserin |4 aut | |
| 700 | 1 | |a Roten, Laurent |e verfasserin |4 aut | |
| 700 | 1 | |a Reichlin, Tobias |e verfasserin |4 aut | |
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