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Clinical efficacy of “ICE-FIRE” ablation for non-paroxysmal atrial fibrillation

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Catheter ablation is less successful for non-paroxysmal atrial fibrillation (NPAF) according to numerous follow-up studies. The choice of ablation strategy for patients with NPAF remains controversial. The objective of the study was to explore the clinical efficacy of the “ICE-FIRE” ablation.

Methods

Ninety NPAF patients were enrolled. Patients were randomly divided into RF (treated with circumferential pulmonary vein isolation (CPVI) and additional substrate modification by radiofrequency ablation) group and I-F (treated with CPVI by cryoablation and additional substrate modification by radiofrequency ablation) group. After CPVI and cardioversion to sinus rhythm, high-density mapping was performed. Eight-one of 90 participants restored to sinus rhythm. Seventy-four of 81 NPAF patients showed low-voltage zone. Substrates with low-voltage zone were targeted for further modification. Participants were followed at baseline, 3, 6, 9, and 12 months after the initial ablation.

Results

The I-F group shared more X-ray exposure (I-F, 264.4 ± 97.4 mGy; RF, 224.9 ± 62.0 mGy; P = 0.039) and less duration of the procedure (I-F, 150.3 ± 27.5 min; RF, 174.2 ± 38.5 min; P = 0.003) compared to RF group. The freedom from atrial arrhythmia recurrence at 12 months post-ablation was similar between the RF and I-F groups (RF, 57.1%; I-F, 71.8%; P = 0.197). However, I-F group experienced lower rehospitalization rate of AF recurrence (RF, 42.9%; I-F, 20.5%; P = 0.038).

Conclusions

In NPAF patients requiring substrate mapping and modification, the “ICE-FIRE” ablation demonstrated non-inferior clinical efficacy and lower rehospitalization rate of AF recurrence when compared with pure radiofrequency ablation strategy.

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Author notes

  1. Gang Xu, Jiageng Cai and Zhaohong Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Hexi District, Tianjin, 300211, People’s Republic of China

    Gang Xu, Jiageng Cai, Zhaohong Liu, Enzhao Liu, Xiangyang Jing, Tong Liu, Qitong Zhang, Lan Ye & Guangping Li

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  1. Gang Xu
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  2. Jiageng Cai
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Correspondence to Enzhao Liu.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional (medical ethics committee of Second Hospital of Tianjin Medical University, KL2019K013) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Xu, G., Cai, J., Liu, Z. et al. Clinical efficacy of “ICE-FIRE” ablation for non-paroxysmal atrial fibrillation. J Interv Card Electrophysiol 60, 205–211 (2021). https://doi.org/10.1007/s10840-020-00725-x

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  • DOI: https://doi.org/10.1007/s10840-020-00725-x

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