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Comparison of atrial fibrillation ablation using cryoballoon versus radiofrequency in patients with left common pulmonary veins: mid-term follow-up results

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Abstract

Purpose

Cryoballoon (CB) and radiofrequency (RF) ablation techniques have similar outcomes for pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). However, there is limited data about the impact of different ablation strategies in patients with left common pulmonary vein (LCPV). Our aim was to compare the safety and efficacy of RF and CB ablation in AF patients with LCPV.

Methods

One hundred and twenty-seven (n = 80 CB and n = 47 RF) AF patients with LCPV detected by preprocedural computerized tomography (CT) were included in the study. Ostial dimensions and trunk distance were measured in all patients. Atrial tachyarrhythmia (ATa) recurrence was defined as detection of AF, atrial flutter, or atrial tachycardia (≥ 30 s) after a 3-month blanking period.

Results

There was no significant difference in acute procedural success rates for PVI (97.5% in CB and 97.9% in RF, respectively, P = 0.953) and complication rates were similar between the groups (6 (7.5%) in CB and 4 (8.5%) in RF, respectively, P = 1.000). During a median follow-up of 20.7 (4.8–50.2) months for CB and 20.5 (6.2–36.0) months for RF, ATa recurrence was 35.0% and 38.2%, respectively (P = 0.777). Multivariate analysis did not reveal any of the morphologic parameters of LCPV as a significant predictor of ATa recurrence.

Conclusions

Our findings demonstrated that both CB and RF ablation techniques have similar efficacy and safety in AF patients with LCPV during the mid-term follow-up.

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Authors and Affiliations

  1. Department of Cardiology, Ankara City Hospital, Ankara, Turkey

    Cem Çöteli

  2. Department of Cardiology, Eskişehir Osmangazi University School of Medicine, 26040, Odunpazari, Eskisehir, Turkey

    Muhammet Dural

  3. Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hacettepe University School of Medicine, Ankara, Turkey

    Yusuf Ziya Şener, Ahmet Hakan Ateş, Metin Okşul, Hikmet Yorgun & Kudret Aytemir

  4. Hacettepe University School of Medicine, Ankara, Turkey

    Mert Ruşen Gülşen & Fahrünisa Meryem Betül Erol

  5. Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey

    Burak Sezenöz

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  1. Cem Çöteli
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Corresponding author

Correspondence to Muhammet Dural.

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The study was in compliance with the principles outlined in the Declaration of Helsinki and approved by the Institutional Ethics Committee.

Conflict of interest

Hikmet Yorgun: proctoring and lecturer for Abbott, proctoring for Medtronic.

Kudret Aytemir: proctoring and lecturer for Abbott, proctoring and lecturer for Medtronic, proctoring for Biosense Webster.

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Çöteli, C., Dural, M., Şener, Y.Z. et al. Comparison of atrial fibrillation ablation using cryoballoon versus radiofrequency in patients with left common pulmonary veins: mid-term follow-up results. J Interv Card Electrophysiol 64, 597–605 (2022). https://doi.org/10.1007/s10840-021-01084-x

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