Comparison of Cryoballoon and Contact Force-Sensing Radiofrequency Ablation for Persistent Atrial Fibrillation in Clinical Practice

Kobori, Atsushi; Sasaki, Yasuhiro; Pak, Misun; Ishikura, Masahiro; Murai, Ryosuke; Okada, Taiji; Takahashi, Toshiaki; Taniguchi, Tomohiko; Kim, Kitae; Ehara, Natsuhiko; Kinoshita, Makoto; Kihara, Yasuki; Furukawa, Yutaka

doi:10.1253/circj.cj-21-0608

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…Comparisons of CF-assisted PVI with non-CF PVI were often conducted in rather small patient groups with a majority of patients presenting with paroxysmal AF without multivariate statistical analysis [ 21 – 25 ]. Various studies compared different catheter technologies or older catheter types to CF-guided PVI [ 22 , 25 – 29 ]. Recent meta-analyses included all available studies to date [ 11 – 13 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of open-irrigated radiofrequency catheter with contact force measurement on the efficacy and safety of atrial fibrillation ablation: a single-center direct comparison

Schlögl

Bengel

et al. 2022

J Interv Card Electrophysiol

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Background In atrial fibrillation (AF) patients, catheter ablation of pulmonary veins (PVI) is the most effective therapeutic option to maintain sinus rhythm. To improve successful PVI, contact force–sensing (CF) catheters became routinely available. Previous studies did not clearly show superior clinical efficacy in comparison with non-CF catheters. Methods We investigated consecutive patients, who underwent index PVI for AF at our hospital between 2012 and 2018. Three hundred and fifty-four patients were ablated without CF. After availability of CF catheters in 2016, 317 patients were ablated using CF. In case of crossover between the groups, follow-up was censored. The primary endpoint was any documented atrial tachycardia (AT) or atrial fibrillation > 30 s after a 3-month blanking period. Secondary endpoints were procedural characteristics and periprocedural complications. Results There was no significant difference between the groups at baseline except hyperlipidemia. After 365 days of follow-up, 67% of patients in the CF group remained free from AF/AT recurrence compared to 59% in non-CF group (P = 0.038). In multivariable Cox regression analysis, non-CF ablation was an independent risk factor for AF recurrence besides age and persistent AF. Total fluoroscopy time (15 ± 7.6 vs. 28 ± 15.9 min) and total procedure time (114 ± 29.6 vs. 136 ± 38.5 min) were significantly lower for CF-guided PVI (P < 0.001). Complication rates did not differ between groups (P = 0.661). Conclusions In our study, the AT/AF recurrence rate and pulmonary vein reconnection rate is lower after CF PVI with a similar complication rate but lower total procedure time and total fluoroscopy time compared to non-CF PVI.

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Section: Discussionmentioning

confidence: 99%

Impact of open-irrigated radiofrequency catheter with contact force measurement on the efficacy and safety of atrial fibrillation ablation: a single-center direct comparison

Schlögl

Bengel

et al. 2022

J Interv Card Electrophysiol

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“…The EPS and ablation procedures were performed as previously described 11 . Catheter ablation was performed under conscious sedation using dexmedetomidine, thiopental, and fentanyl.…”

Section: Methodsmentioning

confidence: 99%

“…The EPS and ablation procedures were performed as previously described. 11 Catheter ablation was performed under conscious sedation using dexmedetomidine, thiopental, and fentanyl. A multipolar catheter with internal cardioversion (BeeAT; Japan-Life-Line) was placed in the coronary sinus through the internal jugular vein, and a deflectable multipolar catheter was placed in the right ventricle or RA through the right femoral vein.…”

Section: Electrophysiological Study (Eps) and Catheter Ablationmentioning

confidence: 99%

Importance of the relative epicardial connection locations and right‐sided pulmonary vein isolation line for successful pulmonary vein isolation

Ishikura

Kobori

Sasaki

et al. 2023

Cardiovasc electrophysiol

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Introduction The presence of an epicardial connection (EC) decreases the success rate of pulmonary vein isolation (PVI); however, the effect of designing isolation lines has not been evaluated. We sought to clarify the effects of designing an anterior line for right‐sided PVI considering the presence and location of the EC. Methods Seventy‐four consecutive patients who underwent initial catheter ablation for atrial fibrillation were retrospectively included in this study. The presence of the EC was determined by the left atrial (LA) activation map during right atrial pacing, and patients were divided into EC‐positive (n = 23, 31%) and EC‐negative (n = 51, 69%) groups. EC‐positive patients were further subdivided based on the EC location: on‐the‐line group, (EC on the PVI line, n = 11); inside‐line group (EC on the pulmonary vein [PV] side, n = 10); and outside‐line group (EC on the LA side, n = 2). The PVI parameters were compared among the three groups. Results The success rates of the first‐pass isolation were comparable between the EC‐negative and EC‐positive groups (70.6% vs. 60.9%, ns), but the success rate was significantly higher in the on‐the‐line group than in the inside‐line group (91% vs. 20%, p = 0.002). First‐pass isolation was successful in both patients in the outside‐line group. Additional carina ablation was required only in the inside‐line group. Conclusions The association between the EC site and the right‐sided PV anterior isolation line affected the success rate of first‐pass isolation. For successful right‐sided PVI, it is important to consider the EC site when designing the PVI line.

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“…The electrophysiological study (EPS) and ablation procedures were performed as previously described. 11 Catheter ablation was performed under conscious sedation using dexmedetomidine, thiopental, and fentanyl. A multipolar catheter with internal cardioversion (BeeAT, Japan-Life-Line, Tokyo, Japan) was placed in the coronary sinus through the internal jugular vein, and a deflectable multipolar catheter was placed in the right ventricle or RA through the right femoral vein.…”

Section: Electrophysiological Study and Catheter Ablationmentioning

confidence: 99%

Importance of the relative epicardial connection locations and right-sided pulmonary vein isolation line for successful pulmonary vein isolation

Ishikura¹,

Kobori²,

Sasaki³

et al. 2022

Preprint

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Background: The presence of an epicardial connection (EC) decreases the success rate of pulmonary vein isolation (PVI); however, the effect of designing isolation lines has not been evaluated. Objective: We sought to clarify the effects of designing an anterior line for right-sided PVI considering the presence and location of the EC. Methods: Seventy-four consecutive patients who underwent initial catheter ablation for atrial fibrillation were retrospectively included in this study. The presence of the EC was determined by the left atrial (LA) activation map during right atrial pacing, and patients were divided into EC-positive (n=23, 31%) and EC-negative (n=51, 69%) groups. EC-positive patients were further subdivided based on the EC location: on-the-line group, (EC on the PVI line, n=11); inside-line group (EC on the pulmonary vein [PV] side, n=10); and outside-line group (EC on the LA side, n=2). The PVI parameters were compared among the three groups. Results: The success rates of the first-pass isolation were comparable between the EC-negative and EC-positive groups (70.6% vs. 60.9%, ns), but the success rate was significantly higher in the on-the-line group than in the inside-line group (91% vs. 20%, p=0.002). First-pass isolation was successful in both patients in the outside-line group. Additional carina ablation was required only in the inside-line group. Conclusions: The association between the EC site and the right-sided PV anterior isolation line affected the success rate of first-pass isolation. For successful right-sided PVI, it is important to consider the EC site when designing the PVI line.

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Comparison of Cryoballoon and Contact Force-Sensing Radiofrequency Ablation for Persistent Atrial Fibrillation in Clinical Practice

Cited by 7 publications

References 28 publications

Impact of open-irrigated radiofrequency catheter with contact force measurement on the efficacy and safety of atrial fibrillation ablation: a single-center direct comparison

Impact of open-irrigated radiofrequency catheter with contact force measurement on the efficacy and safety of atrial fibrillation ablation: a single-center direct comparison

Importance of the relative epicardial connection locations and right‐sided pulmonary vein isolation line for successful pulmonary vein isolation

Importance of the relative epicardial connection locations and right-sided pulmonary vein isolation line for successful pulmonary vein isolation

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