ISSN 2996-8215
International Journal of Cardiology | Vol. 3, No. 10, October 2012 | pp. 73–80
DOI: 10.46882/2012/IJC/000043
Original Research Article
Efficacy of Intredit-Access Cryoballoon Ablation versus Radiofrequency Ablation for Paroxysmal Atrial Fibrillation
Guillaume Mercier¹, Pierre-Yves Roy¹, Jean-François Lebeau²
¹Department of Cardiac Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, Bordeaux, France
²Division of Cardiology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
Abstract:
Pulmonary vein isolation (PVI) is the gold standard interventional therapy for symptomatic paroxysmal atrial fibrillation (AF). Point-by-point radiofrequency (RF) ablation is highly effective but technically demanding and time-consuming. Cryoballoon (CB) ablation has been introduced as a simplified single-shot alternative for achieving PVI. This randomized trial compared procedural characteristics, safety, and 12-month efficacy between second-generation cryoballoon and conventional RF ablation. We randomized 160 patients with symptomatic paroxysmal AF refractory to antiarrhythmic drugs to undergo either CB ablation (n = 80) or irrigated RF ablation (n = 80). The primary efficacy endpoint was freedom from any documented atrial tachyarrhythmia lasting longer than 30 seconds after a 90-day blanking period without antiarrhythmic drugs. CB ablation demonstrated significantly shorter total procedure times (92 ± 18 minutes vs. 134 ± 24 minutes, p < 0.001) and shorter left atrial dwell times (54 ± 12 minutes vs. 88 ± 16 minutes, p < 0.001) compared with RF ablation. Total fluoroscopy time was slightly longer in the CB cohort (16.4 ± 4.2 minutes vs. 12.1 ± 3.5 minutes, p = 0.01). At 12 months, freedom from recurrent arrhythmia was achieved in 73.8% of the CB group and 71.3% of the RF group (p = 0.72), confirming non-inferiority. Transient phrenic nerve injury occurred in 3.8% of CB procedures, all resolving prior to hospital discharge. Major vascular complications did not differ between cohorts (2.5% vs. 1.3%, p = 0.56). Cryoballoon ablation achieves 12-month success rates equivalent to open-irrigated radiofrequency ablation for paroxysmal atrial fibrillation, while significantly reducing procedural duration and left atrial instrument manipulation times.
Keywords: Atrial fibrillation, Pulmonary vein isolation, Cryoballoon ablation, Radiofrequency ablation, Procedural efficiency, Rhythm control
Received: July 05, 2012; Revised: August 19, 2012; Accepted: September 10, 2012; Published: October 22, 2012
Citation: International Journal of Cardiology, 2012, Vol. 3, No. 10, pp. 73–80, DOI: 10.46882/2012/IJC/000043