P1107Different technologies for pulmonary vein isolation of patients with paroxysmal atrial fibrillation

Adil K. Baimbetov, T Bozshagulov, Ye. Ye. Abilkhanov, I Yakupova, Kenzhebek A. Bizhanov, K Yergeshov

2018

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DOI 10.1093/europace/euy015.593
Data confidence 70 medium
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Abstract

Background: Cryoballoon pulmonary vein isolation (PVI) has been developed as a alternative technology for ablation of atrial fibrillation (AF). Our objective is to compare different technologies for ablation results using cryoballoon second generation (Cryo-PVI) and radiofrequency energy (RF-PVI) during 2 year follow-up. Methods: Cryo-PVI was performed in 155 patients using a 28-mm cryoballoon ablation catheter (Arctic Front Advance, MDT). 145 patients undergoing RF-PVI using irrigated RF ablation catheter and navigation mapping system (Carto 3, BW) served as a control group. The procedural endpoint was PVI confirmed by a circumferential mapping catheter. Follow-up was performed 6, 9, 12, 18 and 24 month after the procedure, using by 24-Hour ECG Holter Monitor. Results: This study included 300 patients with paroxysmal atrial fibrillation (age 56±13 years, left atrial size 40±4 mm). After single procedure and during 1 year follow-up 111 patients (71,6%) were free from AF without antiarrhythmic drugs (AAD) in the Cryo-PVI group. In the RF-PVI group 103 patients (71,1%) had sinus rhythm without AAD. Significantly differences were procedure and fluoroscopy duration – 112±27 and 19,5±5,7 in the Cryo-PVI group versus 154±42 and 32±9,3 in the RF-PVI group (p<0,001). When including repeat procedures with a mean of 1,5±0,5 procedures per patient, 39 of 155 patients (25,2%) in the Cryo-PVI group and 37 of 145 patients (25,5%) in the RF-PVI group (1,4±0,6 procedures per patient) remained in stable sinus rhythm without AAD. Conclusion: Single procedure efficacy of PVI is approximately 71% during 2 year follow-up and this is independent of the energy source used, but significantly difference of approaches were procedure and fluoroscopy durations (p<0,001). When including repeat procedures in 25% of patients, outcomes is increased to approximately 85%.