Archief Roodbont

Cryoballoon ablation more effective for paroxysmal than persistent AF

12 April 2011

MedWire News: A single cryoballoon ablation procedure is more effective at preventing 1-year recurrence of atrial fibrillation (AF) in patients with paroxysmal rather than persistent forms of the arrhythmia, show findings of a systematic review.

Researchers led by Marc Dubuc, from Université de Montréal in Canada, reviewed 23 studies involving cryoballoon ablation in 1221 patients with paroxysmal and 87 patients with persistent AF.

As reported in the journal Heart Rhythm, the patients had a mean age of 57.5 years, and a mean AF duration of 4.7 years.

Irrespective of AF type, more than 90% of patients had acute procedural success, defined as restoration of sinus rhythm immediately after ablation, and approximately 95% of all pulmonary veins targeted during ablation were successfully isolated.

Discounting the 3-month blanking period occurring immediately after ablation, 1-year freedom from AF recurrence occurred at a rate of 73% among patients with paroxysmal AF.

In patients with persistent AF, however, this rate of freedom from AF recurrence was only 45%.

Dubuc and team report that cryoballoon ablation produced a low rate of adverse events, with the commonest complication, transient phrenic nerve palsy, occurring at a rate of 6.3%. Other typical ablation-associated complications, namely left atrial-esophageal fistulae and pulmonary vein stenosis, occurred at very low rates of less than 1.0%.

Stroke or transient ischemic attack also occurred at a low rate of 0.3%.

“Further studies, including direct comparison to conventional radiofrequency ablation, are ongoing and will provide important insight into long-term efficacy and safety,” conclude Dubuc and team.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

Heart Rhythm 2011; Advance online publication