Safety and Efficacy of Different Catheter Ablations for Atrial Fibrillation: A Systematic Review and Meta‐Analysis

Liu, Xiaohua; Chaofeng, Chen; Gao, Xiaofei; Xu, Yizhou

doi:10.1111/pace.12889

Cited by 19 publications

(8 citation statements)

References 56 publications

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“…Cryotherapy was associated with shorter ablation time, but higher fluoroscopy time. Overall complication rate was 5.1% in our study, lower than the 13.5% rate reported in the Sustained Treatment of paroxysmal Atrial Fibrillation (STOP AF) trial [12]. However a large recently published metaanalysis shown that cryoballoon ablation seems to be associated with greater freedom from AF, shorter procedural time, and lower rate of major complications, compared with radiofrequency ablation [13].…”

Section: Resultscontrasting

confidence: 67%

Outcomes and predictors of recurrences after pulmonary vein isolation by cryoballoon or radiofrequency catheter atrial fibrillation ablation

Grecu¹,

Floria²,

Hurjui³

et al. 2017

Arch Clin Cases

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Aim: Catheter-based pulmonary vein isolation (PVI) has become a new option treatment for drug-resistant and symptomatic paroxysmal atrial fibrillation (AF). We aimed to assess the outcomes after radiofrequency and cryoballoon catheter AF ablation. Material and methods: We performed a single-center prospective clinical study enrolling patients who underwent catheter ablation for paroxysmal AF between 2013 and 2015. The main objective was the outcomes after AF ablation by cryoballoon or radiofrequency energy. Follow-up was performed at 3, 6 and 12 months after ablation. Results: A total of 85 patients were included: 64 assigned to radiofrequency and 21 to cryoballoon ablation. Overall success rate at 3, 6 and 12 months post-ablation was 62%, 76% and 75%, respectively. Redo procedure was required in 8 patients (10.3%) at 6 months. Success rate at 12 months was non-significantly higher in radiofrequency ablation group (76% versus 62%; p=0.56). Complication rates were equivalent, without life treating or permanent sequels. Men gender, AF duration, obesity and sleep apnoea syndrome were clinical predictors of AF recurrence at 12 months after procedure. Conclusions: Cryoballoon and radiofrequency ablation appear to be safe and effective procedures for AF treatment, with similar success rate. Men gender, AF duration, obesity and sleep apnea syndrome seem to be associated with AF recurrence after ablation.

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Section: Resultscontrasting

confidence: 67%

Outcomes and predictors of recurrences after pulmonary vein isolation by cryoballoon or radiofrequency catheter atrial fibrillation ablation

Grecu¹,

Floria²,

Hurjui³

et al. 2017

Arch Clin Cases

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“…There have been two meta-analyses about pAF ablation published recently, but these studies differ significantly in the study inclusion criteria from our study. Xu et al (2016) published a meta-analysis this year that included retrospective, prospective, randomized and nonrandomized studies. Furthermore, all different ablation methods and all different stages of AF (pAF, persistent and permanent) were included.…”

Section: Strengths and Weaknesses In Relation To Other Studiesmentioning

confidence: 99%

Cryoballoon versus radiofrequency ablation for paroxysmal atrial fibrillation: a meta-analysis of randomized controlled trials

et al. 2018

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“…Recently, several RFC versus cryoballoon studies have been reported, and meta-analyses of these trials have demonstrated that RFC and cryoballoon share similar efficacy and safety profiles [ 7 – 10 ]. In fact, the FIRE AND ICE trial is the largest multicenter prospective randomized trial on catheter ablation, and this trial also demonstrated an equivalency between catheter groups with regard to safety and efficacy [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, a true comparison of RFC versus cryoballoon technology should be done in a large randomized population while using ILRs. Neither FIRE AND ICE nor the current meta-analyses use ILRs [ 5 – 10 ], and the true results of RFC efficacy could be overestimated while by comparison the cryoballoon results may be underestimated.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency versus Cryoballoon Ablation of Atrial Fibrillation: An Evaluation Using ECG, Holter Monitoring, and Implantable Loop Recorders to Monitor Absolute and Clinical Effectiveness

Davtyan

Shatakhtsyan

Poghosyan³

et al. 2018

BioMed Research International

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Introduction While several studies have compared the radiofrequency current (RFC) and cryoablation for the treatment of patients with atrial fibrillation (AF), no study has monitored the long-term outcomes with the usage of implantable loop recorders (ILRs). Methods We enrolled 89 consecutive patients with nonvalvular paroxysmal AF (N = 44 for RFC and N = 45 for cryoballoon). The primary efficacy end point was the assessment of effectiveness for each group (RFC versus cryoballoon) when examining freedom from arrhythmia by monitoring with ECG, Holter, and implantable loop recoder (ILR). The primary safety end point compared rates of adverse events between both groups. The secondary efficacy end point examined the duration of the postablation blanking period from ILR retrieved data. Results The mean age of the study population was 56.6 ± 10.2 years, and the follow-up duration was 12 months. There were no differences in baseline patient characteristics between groups. At 12 months, the absolute effectiveness (measured by ILR) was 65.9% in the RFC group and 51.1% in the cryoballoon group (OR = 1.85; 95% CI: 0.79–4.35; p = 0.157), and the clinical effectiveness (measured by ECG and Holter) was 81.8% in the RFC group and 55.6% in the cryoballoon group (OR = 3.6; 95% CI: 1.37–9.46; p = 0.008). There was no difference in safety between both groups. Asymptomatic episodes were significantly more present in the RFC group as measured by ILRs (p < 0.010). In cryoballoon group, arrhythmia episodes were recorded equally irrespective of the follow-up method (i.e., ECG and Holter versus ILR (p > 0.010)). The blanking period does not seem to be as important in cryoballoon as compared to RFC. Conclusion RFC and cryoballoon ablation had similar absolute effectiveness at 12 months. ECG and Holter were effective when assessing the efficacy of the cryoballoon ablation; however, in the RFC group, ILR was necessary to accurately assess long-term efficacy.

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Safety and Efficacy of Different Catheter Ablations for Atrial Fibrillation: A Systematic Review and Meta‐Analysis

Cited by 19 publications

References 56 publications

Outcomes and predictors of recurrences after pulmonary vein isolation by cryoballoon or radiofrequency catheter atrial fibrillation ablation

Outcomes and predictors of recurrences after pulmonary vein isolation by cryoballoon or radiofrequency catheter atrial fibrillation ablation

Cryoballoon versus radiofrequency ablation for paroxysmal atrial fibrillation: a meta-analysis of randomized controlled trials

Radiofrequency versus Cryoballoon Ablation of Atrial Fibrillation: An Evaluation Using ECG, Holter Monitoring, and Implantable Loop Recorders to Monitor Absolute and Clinical Effectiveness

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