Cardiovascular Disease |

A Comparison of Efficacy Among Radiofrequency Ablation, Cryoballoon Ablation, and Combined Cryoballoon and Radiofrequency Approaches FREE TO VIEW

David Snipelisky, MD; Jordan Ray; Ryan Ung; Melissa Duart; Christine Kauffman; Fred Kusumoto
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Mayo Clinic, Rochester, MN

Chest. 2015;148(4_MeetingAbstracts):61A. doi:10.1378/chest.2281628
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SESSION TITLE: Cardiovascular Disease Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Radiofrequency and cryoballoon ablation techniques have become more widely used in patients with difficult to manage atrial fibrillation. A significant number of patients have persistent symptoms despite appropriate medical management, necessitating an invasive, nonpharmacologic approach. Multiple energy sources can be used for ablation of atrial fibrillation, and it is unclear whether clinical outcomes are affected by different techniques.

METHODS: All patients undergoing ablation for atrial fibrillation within the past 3 years were assessed. Clinical, laboratory, and electrocardiographic data were evaluated. Patients were divided into subsets based on the type of ablative procedure (radiofrequency, cryoballoon, or hybrid approach using both cryoballoon and radiofrequency energy). Success rates in maintenance of sinus rhythm immediately post-ablation and at the latest follow-up were compared.

RESULTS: A total of 276 patients met inclusion criteria, of which 107 underwent radiofrequency ablation, 93 cryoballoon ablation, and 76 a combined cryoballoon and radiofrequency ablation approach. A similar number of patients were noted to be in normal sinus rhythm both immediately following ablation (p=0.922) and at follow-up (p=0.589). Fewer patients in the cryoablation subset (p=0.003) required anti-arrhythmic medications or additional cardiac procedures such as repeat ablation or cardioversion. Patients in the radiofrequency subset were more likely to have periand post- procedure bleeding complications (n=19, 17.8%) compared to the combined (n=7, 9.2%) and cryoballoon (n=6, 6.5%) approaches (p=0.023).

CONCLUSIONS: Cryoballoon ablation may offer both safety and outcome benefits in the treatment of atrial fibrillation when compared with either a radiofrequency or a combined hybrid approach.

CLINICAL IMPLICATIONS: Providers should be aware of the efficacy and complication rates when deciding on which procedure to use in the ablation of atrial fibrillation.

DISCLOSURE: The following authors have nothing to disclose: David Snipelisky, Jordan Ray, Ryan Ung, Melissa Duart, Christine Kauffman, Fred Kusumoto

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