Ang, R;
Hunter, RJ;
Lim, WY;
Opel, A;
Ullah, W;
Providencia, R;
Baker, V;
... Schilling, RJ; + view all
(2018)
Long term outcome and pulmonary vein reconnection of patients undergoing cryoablation and/or radiofrequency ablation: Results from the cryo versus RF Trial.
Journal of Atrial Fibrillation
, 11
(3)
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Bebiano Da Providencia E Costa_Long term outcome and pulmonary vein reconnection of patients undergoing cryoablation_VoR.pdf - Published Version Download (877kB) | Preview |
Abstract
Introduction:Long term prospective data comparing the efficacy of radiofrequency (RF) and cryoballoon ablation (CRYO) for paroxysmal atrial fibrillation (PAF) is lacking. We report the long-Term outcomes of a randomized control trial comparing CRYO to RF ablation, or a novel COMBINED approach (RF followed by CRYO) for PAF. We studied the number and pattern of pulmonary vein (PV) reconnections in patients undergoing repeat procedure(s). The COMBINED approach had significantly higher single procedure success rate and is associated with the fewest reconnected PVs. Methods: 203 patients who underwent first time PAF ablation in a randomized clinical trial comparing CRYO (67), RF (67) and COMBINED (69) approaches were followed up. All patients with symptomatic recurrence of AF were offered a repeat procedure(s). Reconnected PV(s) at repeat procedure(s) were recorded. In a subset, the PV reconnection sites during the first repeat procedure were prospectively assessed and categorised into one of 8 segments. Results: At 5 years, 57% of COMBINED patients remained free of AF after a single procedure compared to 47% CRYO and 19% RF patients (p<0.001 COMBINED vs RF and CRYO vs RF, p=0.043 COMBINED vs CRYO). During the first repeat procedure, the COMBINED group had less number of reconnected PVs (mean number of reconnected PVs in the COMBINED group 1.2 vs 2.3 CRYO and 2.4 RF, p=0.034). There was a different pattern of PV reconnection comparing the CRYO and RF groups. Conclusion:The COMBINED approach had a significantly higher single procedure success rate with fewer reconnected PVs and fewer reconnection sites compared to either CRYO or RF alone. CRYO in turn was superior to RF. PV reconnection pattern differed between CRYO and RF and the synergistic effect of the COMBINED approach may explain the improved single procedure efficacy.
| Type: | Article |
|---|---|
| Title: | Long term outcome and pulmonary vein reconnection of patients undergoing cryoablation and/or radiofrequency ablation: Results from the cryo versus RF Trial |
| Open access status: | An open access version is available from UCL Discovery |
| Publisher version: | http://jafib.com/published.php?type=full&id=2072&i... |
| Language: | English |
| Additional information: | Copyright © Authors 2018. The CardioFront Inc and Jafib Team apply the Creative Commons Attribution License (CCAL) to all works they publish in Journal of Atrial Fibrillation (JAFIB). Under the CCAL, authors retain ownership of the copyright for their article, but authors allow anyone to download, reuse, reprint, modify, distribute, and/or copy articles in JAFIB, so long as the original authors and source are cited. No separate permission is required from the authors or the publishers. |
| Keywords: | Atrial Fibrillation, Catheter Ablation, Radio frequency Catheter Ablation, Cryo Balloon Ablation, Pulmonary Vein Reconnection, Long Term Outcomes |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10068579 |
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