cryoballoon ablation are established treatments for atrial fibrillation.
Frequently, substrate modification of the left atrium is performed in patients
with persistent AF or extensive atrial substrate abnormalities. We compared one
year outcomes of AF ablation with substrate modification utilizing
radiofrequency catheter ablation (RFA) compared to a combination of cryoballoon
ablation with radiofrequency catheter ablation (HAFA).
persistent AF was performed using stand-alone catheter ablation (RFA group, n=31)
or cryoballoon for pulmonary vein isolation with RFA catheter ablation for
substrate modification (HAFA group, n=21) and procedural and clinical outcomes
were analyzed. Pulmonary vein isolation and LA substrate modification including
creation of left atrial ablation lines and/or CFAEs was performed in all
patients. Patients were followed for up to one year. A three- month blinding
window was applied for analysis.
characteristics were similar between groups. Total procedure (244.15±64.7 vs 235.5±54.6,
p=0.6) and fluoroscopy time (37±15.4 vs 29.5±15.7, p=0.96) were not different
between the HAFA and RFA groups, respectively. Periprocedural complications
were similar among groups. AF free survival was not significantly different
between groups (p=0.631). Actuarial arrhythmia recurrence in one year was
similar among groups (58.1% vs 66.7% for the RFA and HAFA group respectively,
p=0.53) Symptomatic improvement was similar at 1 year between groups (81% vs
77.4% for HAFA vs RFA respectively, p=0.76).
cryoballoon and catheter ablation for LA substrate modification (HAFA) has
similar safety and efficacy compared to stand-alone catheter ablation for
persistent AF. Recurrent atrial flutter is more frequently noted after
cryoballoon ablation for persistent AF.
Credits: Ioanna Kosmidou; Kyari Sumayin; Thomas Deering; Andrew Wickliffe; Sricharan Kanitpudi; Stephen Prater; Dan Dan