Long-term comparisons of atrial fibrillation ablation outcomes with a cryoballoon or laser-balloon: A propensity-matched analysis based on continuous rhythm monitoring.

Autor:	Schiavone M; Cardiology Unit, ASST-Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy., Gasperetti A; Cardiology Unit, ASST-Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: alessio.gasperetti3@gmail.com., Montemerlo E; Department of Cardiology, ASST-Monza, San Gerardo Hospital, Monza, Italy., Pozzi M; Department of Cardiology, ASST-Monza, San Gerardo Hospital, Monza, Italy., Sabato F; Cardiology Unit, ASST-Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy., Piazzi E; Department of Cardiology, ASST-Monza, San Gerardo Hospital, Monza, Italy., Ruggiero D; Cardiology Unit, ASST-Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy., De Ceglia S; Department of Cardiology, ASST-Monza, San Gerardo Hospital, Monza, Italy., Viecca M; Cardiology Unit, ASST-Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy., Calkins H; Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Rovaris G; Department of Cardiology, ASST-Monza, San Gerardo Hospital, Monza, Italy., Forleo GB; Cardiology Unit, ASST-Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.
Jazyk:	angličtina
Zdroj:	Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese [Hellenic J Cardiol] 2022 May-Jun; Vol. 65, pp. 1-7. Date of Electronic Publication: 2022 Mar 22.
DOI:	10.1016/j.hjc.2022.03.006
Abstrakt:	Objective: Cryoballoon (CB) and laser-balloon (LB) catheter ablation (CA) has been demonstrated to achieve durable and effective pulmonary vein isolation (PVI). Only one head-to-head comparison with an intermittent rhythm monitor strategy is currently available. The aim of this study was to compare acute and long-term outcomes of CB and LB atrial fibrillation ablation procedures, by using a continuous rhythm monitoring strategy. Methods: This was a prospective two-arm nonrandomized propensity-matched observational trial that compared the outcomes of atrial fibrillation (AF) ablation using LB and CB techniques. To evaluate AF recurrences, an implantable cardiac monitor (ICM) was implanted before hospital discharge to detect atrial tachyarrhythmia (ATA) recurrences. Results: A total of 110 propensity-matched patients undergoing AF ablation with an LB (n = 55) or with a CB system (n = 55) were enrolled (paroxysmal AF 57.3%). Procedural time (LB: 87 [73-104] vs. CB 90 [70-130] min; p = 0.264) and fluoroscopy time did not differ. No differences in ATA recurrences were observed at 12 months (LB-30.9% vs. CB-29.1% and LB-45.5% vs. CB-38.2%; log-rank 0.539). As for AF burden, the 12-month median was 0 [0-1] vs. 0 [0-3]% (p = 0.127) in the LB and CB groups, respectively. When considering only PeAF patients, the median 12-month ATA burden was 26 [18.5-40.5] vs. 29 [26-35]% (p = 0.919) for the LB and CB patients, respectively. Conclusion: In a propensity-matched cohort undergoing AF ablation, arrhythmia outcomes assessed by continuous rhythm monitoring did not differ between LB and CB, with an overall low ATA burden. The only predictor of recurrences was persistent AF. There was no difference in procedure or fluoroscopy time. (Copyright © 2022 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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