Comparison between radiofrequency with contact force-sensing and second-generation cryoballoon for paroxysmal atrial fibrillation catheter ablation: a multicentre European evaluation

Squara, Fabien; Zhao, Alexandre; Marijon, Éloi; Laţcu, Decebal Gabriel; Providência, Rui; Giovanni, Giacomo Di; Jauvert, Gaël; Jourda, François; Chierchia, Gian Battista; Asmundis, Carlo de; Ciconte, Giuseppe; Alonso, Christine; Grimard, Caroline; Boveda, Serge; Cauchemez, B; Saoudi, Nadir; Brugada, Pedro; Albenque, Jean Paul; Thomas, Olivier

doi:10.1093/europace/euv060

Cited by 137 publications

(108 citation statements)

References 24 publications

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“…In a study comparing RF CA using contact force and the second-generation cryoballoon, the overall freedom from AF was similar in both groups at 18 months. However, the procedural time was shorter in the cryoablation group albeit with a higher incidence of phrenic nerve palsy 74 . The ongoing FIRE And ICE study, is a multicenter randomized control study comparing the second-generation cryoballoon to that of standard RF ablation.…”

Section: Accepted Manuscriptmentioning

confidence: 86%

Atrial Fibrillation Ablation: Indications, Emerging Techniques, and Follow-Up

Gerstenfeld

Duggirala

2015

Progress in Cardiovascular Diseases

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Section: Accepted Manuscriptmentioning

confidence: 86%

Atrial Fibrillation Ablation: Indications, Emerging Techniques, and Follow-Up

Gerstenfeld

Duggirala

2015

Progress in Cardiovascular Diseases

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“…In addition, the overall complication rate was similar in the CB and CF groups (7.3 % versus 7.1 %; p=0.93). 26 In another study comparing the two techniques, 56 consecutive patients underwent a repeat ablation due to recurrent atrial tachyarrhythmias after the index PVI achieved with CF ablation (30 patients) or CB ablation (26 patients). The percentage of reconnected PVs was significantly lower following CB procedures than with CF ablation (36.1 % PVs in the CF catheter ablation group, versus 20.4 % PVs in the secondgeneration CB ablation group; p=0.01).…”

Section: Force Sensing With Rf Ablation Versus Cryo-ablationmentioning

confidence: 99%

Evolution of Force Sensing Technologies

Shah

2017

Arrhythmia &Amp; Electrophysiology Review

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In order to improve the procedural success and long-term outcomes of catheter ablation techniques for atrial fibrillation (AF), an important unfulfilled requirement is to create durable electrophysiologically complete lesions. Measurement of contact force (CF) between the catheter tip and the target tissue can guide physicians to optimise both mapping and ablation procedures. Contact force can affect lesion size and clinical outcomes following catheter ablation of AF. Force sensing technologies have matured since their advent several years ago, and now allow the direct measurement of CF between the catheter tip and the target myocardium in real time. In order to obtain complete durable lesions, catheter tip spatial stability and stable contact force are important. Suboptimal energy delivery, lesion density/ contiguity and/or excessive wall thickness of the pulmonary vein-left atrial (PV-LA) junction may result in conduction recovery at these sites. Lesion assessment tools may help predict and localise electrical weak points resulting in conduction recovery during and after ablation. There is increasing clinical evidence to show that optimal use of CF sensing during ablation can reduce acute PV re-conduction, although prospective randomised studies are desirable to confirm long-term favourable clinical outcomes. In combination with optimised lesion assessment tools, contact force sensing technology has the potential to become the standard of care for all patients undergoing AF catheter ablation.

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“…Nonetheless, clinical 1-year success rate was 88% in our CF-RFA group and 88% in our CBA group, respectively. Recent studies comparing CF-guided RFA with CBA have shown statistical equivalence between the 2 technologies 25) . This may relate to the fact that even focused lesions may eliminate triggers and that not for all transmural continuous lesions around the PVs are needed [26][27][28][29] .…”

Section: Impact Of Different Technique Of Cb Ablation Vsmentioning

confidence: 99%

Dormant Conduction after Second-Generation Cryoballoon-Mediated Pulmonary Vein Isolation for Atrial Fibrillation: Comparison with Contact Force-guided Irrigated-Tip Radiofrequency Ablation

Takahashi

Okumura

Watanabe

et al. 2017

Nichidai Igaku Zasshi

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Background: Both contact force (CF)-guided radiofrequency ablation (RFA) based pulmonary vein isolation (PVI) and second-generation cryoballoon ablation (CBA) based PVI may improve the procedural outcome. However, the clinical outcome after RFA-and CBA-based PVI remains unclear. Adenosine or adenosine triphosphate (ATP) administration after PVI is useful to detect dormant PV conduction (DC) after the ablation procedure, and the presence of DC has been shown to be related to AF recurrence.Methods: Out of 100 patients with paroxysmal AF (PAF), 50 underwent CF-guided PVI (25-30 W, 30 sec for each ablation: CF-RFA group), and the remaining 50 patients underwent cryoballoon ablation-based PVI (3 min cooling + 2 min bonus cooling for each PV: CBA group). Thirty minutes after PVI, a 30-mg bolus of ATP was administered. We compared the success rate of PVI, and incidence of DC after PVI between the CF-RFA and CBA groups.Results: The subsequent response was assessed for each vein using a ring catheter. In the CBA group, 180 (90%) of 200 PVs were isolated and 20 PVs (10%) (2 left superior PV (LSPV), 3 left inferior PV (LIPV), 4 right superior PV (RSPV), 11 right inferior PV (RIPV) from 14 of 50 patients (28%) required additional RFA because of residual potential at the PV or PV antra. After a waiting period of 30 min after the last energy application, acute PV reconduction was observed spontaneously in 13 PVs (6.5%) (6 LSPV, 3 LIPV, 4 RSPV) from 12 patients (24%) in the CF-RFA group. The DC sites provoked by ATP were 13 PVs (6.5%) (5 LSPV, 3 LIPV, 2 RSPV, 3 RIPV) from 8 patients (16%) in the CF-RFA group, compared with 9 PVs (4.5%) (2 LSPV, 4 LIPV, 1 RSPV, 2 RIPV) from 9 CBA patients (18%) (P = 1.000). AF recurred in 6/50 (12%) in both the CF-RFA and CBA groups at 1 year after the ablation (P = 1.000).Conclusions: There was no significant difference in the incidence of DC after PVI and the 12-month AF-free rate between the second-generation CBA-and CF-based RFA.

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Comparison between radiofrequency with contact force-sensing and second-generation cryoballoon for paroxysmal atrial fibrillation catheter ablation: a multicentre European evaluation

Abstract: Pulmonary vein isolation using CF-guided RF and second-generation CB leads to comparable single-procedure arrhythmia-free survival at up to 18 months with similar overall complication rate.

Cited by 137 publications

References 24 publications

Atrial Fibrillation Ablation: Indications, Emerging Techniques, and Follow-Up

Atrial Fibrillation Ablation: Indications, Emerging Techniques, and Follow-Up

Evolution of Force Sensing Technologies

Dormant Conduction after Second-Generation Cryoballoon-Mediated Pulmonary Vein Isolation for Atrial Fibrillation: Comparison with Contact Force-guided Irrigated-Tip Radiofrequency Ablation

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