Abstract
Objectives: The objective of this study was to compare efficiency and safety of pulmonary vein isolation (PVI) catheter ablation for paroxysmal atrial fibrillation (AF) between contact-force (CF)-guided radiofrequency (RF) and second-generation balloon cryotherapy. Methods: Single-center prospective evaluation, carried out from April 2014 to May 2015, comparing CF radiofrequency (Tacticath abbot.) (CF group) with cryoballoon ablation (Arctic Front Advance™ 28 mm cryoballoon, Medtronic, Inc.) (CB group), in regards to procedural safety and efficacy, as well as recurrence at 18 months. Overall, 140 consecutive patients were enrolled (70 in each group). Results: The characteristics of patients of both the groups were similar (51.2 ± 11.9 years, women 40.3%, mean AF duration 5.1 ± 4.0 years, mean CHA2DS2-VASc score 1.9 ± 1.3, mean HAS-BLED 1.7 ± 0.6). Lower duration of fluoroscopy (20.3 ± 8.5 vs. 24.3 ± 9.2 min, P = 0.017) and X-ray exposure (4248 ± 2214 cGy cm² vs. 7334 ± 5141 cGy cm², P = 0.001). with a duration of the procedure was significantly lower in the CF group (105.7 ± 30.5 vs. 129.5 ± 46.3 min, P = 0.001), No significant difference was found regarding significant procedural complication (2.4 vs. 1.2% in CF and CB groups, respectively; P = 0.53), and PVI was eventually achieved in all cases. At 18 months, AF recurrence occurred in 12 patients (17.1%) in the CB group and in 10 patients (14.3%) in the CF group (HR = 1.20 95% CI 0.51–2.92; log rank P = 0.694). Conclusions: There was no significant deference regarding efficacy and safety between contact force-guided radiofrequency and cryotherapy in the setting of paroxysmal AF catheter ablation