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Arrhythmia-free survival and pulmonary vein reconnection patterns after second-generation cryoballoon and contact-force radiofrequency pulmonary vein isolation

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A Correction to this article was published on 06 March 2018

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Abstract

Introduction

The aim of this study was to compare second-generation cryoballoon and contact-force radiofrequency point-by-point pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients with regard to pulmonary vein reconnection and arrhythmia-free survival.

Methods and results

Altogether, 269 consecutive patients with drug-refractory AF undergoing PVI were included and randomly allocated to second-generation cryoballoon or contact-force point-by-point radiofrequency ablation. Median follow-up duration was 389 days (interquartile range 219–599). Mean age was 59 years (71% male); 136 patients underwent cryoballoon and 133 patients underwent radiofrequency ablation. Acute electrical PVI was 100% for both techniques. Procedure duration was significantly shorter in cryoballoon vs radiofrequency (166.5 vs 184.13 min P = 0.016). Complication rates were similar (6.0 vs 6.7%, P = 1.00). Single procedure freedom of atrial arrhythmias was significantly higher in cryoballoon as compared to radiofrequency (75.2 vs 57.4%, P = 0.013). In multivariate analysis, persistent AF, AF duration, and cryoballoon ablation were associated with freedom of atrial tachyarrhythmias. The number of repeat ablation procedures was significantly lower in the cryoballoon compared to radiofrequency (15.0 vs 24.3%, P = 0.045). At repeat ablation, pulmonary vein reconnection rate was significantly lower after cryoballoon as compared to radiofrequency ablation (36.8 vs 58.1%, P = 0.003).

Conclusions

Improved arrhythmia-free survival and more durable pulmonary vein isolation is seen after PVI using second-generation cryoballoon as compared to contact-force radiofrequency, in patients with drug-refractory paroxysmal AF. Complication rates for both ablation techniques are low.

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Change history

  • 06 March 2018

    The name of the author Jaap Jan J. Smit was rendered wrongly in the original publication. The original article has been corrected.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of cardiology, Isala Heart Centre, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands

    Thomas J. Buist, Ahmet Adiyaman, Jaap Jan J. Smit, Anand R. Ramdat Misier & Arif Elvan

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  1. Thomas J. Buist
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  2. Ahmet Adiyaman
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  3. Jaap Jan J. Smit
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  4. Anand R. Ramdat Misier
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  5. Arif Elvan
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Correspondence to Arif Elvan.

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Additional information

The original version of this article was revised: The name of the author Jaap Jan J. Smit was rendered wrongly.

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Buist, T.J., Adiyaman, A., Smit, J.J.J. et al. Arrhythmia-free survival and pulmonary vein reconnection patterns after second-generation cryoballoon and contact-force radiofrequency pulmonary vein isolation. Clin Res Cardiol 107, 498–506 (2018). https://doi.org/10.1007/s00392-018-1211-9

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  • DOI: https://doi.org/10.1007/s00392-018-1211-9

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