loading page

Optimal single procedure strategy of pulmonary vein isolation with cryoballoon or radiofrequency and non-pulmonary vein triggers ablation for non-paroxysmal atrial fibrillation
  • +5
  • Giichi Nitta,
  • Junichi Nitta,
  • Osamu Inaba,
  • Akira Sato,
  • Yukihiro Inamura,
  • Tomomasa Takamiya,
  • Masahiko Goya,
  • Tetsuo Sasano
Giichi Nitta
Japanese Red Cross Saitama Hospital
Author Profile
Junichi Nitta
Sakakibara Heart Institute
Author Profile
Osamu Inaba
Japanese Red Cross Saitama Hospital
Author Profile
Akira Sato
Japanese Red Cross Saitama Hospital
Author Profile
Yukihiro Inamura
Japanese Red Cross Saitama Hospital
Author Profile
Tomomasa Takamiya
Japanese Red Cross Saitama Hospital
Author Profile
Masahiko Goya
Tokyo Medical and Dental University Hospital
Author Profile
Tetsuo Sasano
Tokyo Medical and Dental University
Author Profile

Abstract

Introduction: Limited data exist on pulmonary vein isolation (PVI) using cryoballoon (CB) or radiofrequency (RF) ablation and additional non-pulmonary vein triggers ablation for non-paroxysmal atrial fibrillation (non-PAF). The objective of this study was to assess the outcomes of first-stage catheter ablation for non-PAF patients. Methods and Results: Initial PVI was performed on 734 non-PAF patients (age: 64±10 years; male: 584) between September 2014 and June 2018 [315 (43%), CB ablation; 419 (57%), RF catheter]. A logistic regression model was used to match 257 pairs (514 patients) according to propensity scores (CB group or RF group). After PVI, additional non-PV triggers ablation was performed if induced by isoproterenol. We analyzed the clinical outcomes of both groups. The mean procedural time was significantly shorter in the CB group (125 [range, 89–165] min) than in the RF group (190 [160–224] min; P < 0.001). The 1-year Kaplan-Meier event rate revealed similar atrial fibrillation-free survival rate between the groups (CB: 77.9%, RF: 82.3%; log-rank P = 0.111). The additional ablation percentage for non-PV foci (CB: 39%, RF: 41%; P = 0.653) and the complications incidence (CB: 5%, RF: 4%; P = 0.670) were also similar. Conclusion: In non-PAF patients, PVI using CB or RF ablation and non-PV triggers ablation achieved comparable outcomes. The safety and efficacy of the combination strategy of PVI and non-PV triggers ablation was demonstrated.