Learning curves in atrial fibrillation ablation - A comparison between second generation cryoballoon and contact force sensing radiofrequency catheters

Vedran Velagic; Ivan Prepolec; Vedran Pasara; Mislav Puljevic; Davor Puljevic; Ivo Planinc; Jure Samardzic; Davor Milicic

doi:10.1016/j.ipej.2020.09.003

Learning curves in atrial fibrillation ablation - A comparison between second generation cryoballoon and contact force sensing radiofrequency catheters

Indian Pacing Electrophysiol J. 2020 Nov-Dec;20(6):273-280. doi: 10.1016/j.ipej.2020.09.003. Epub 2020 Sep 30.

Authors

Vedran Velagic¹, Ivan Prepolec², Vedran Pasara², Mislav Puljevic², Davor Puljevic², Ivo Planinc², Jure Samardzic², Davor Milicic²

Affiliations

¹ University of Zagreb School of Medicine, Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Zagreb, Croatia. Electronic address: vvelagic@gmail.com.
² University of Zagreb School of Medicine, Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Zagreb, Croatia.

Abstract

Objective: To examine the learning curves of atrial fibrillation (AF) ablation comparing the cryoballoon (CB) and radiofrequency (RF) catheters.

Methods: We performed a retrospective data analysis from the initiation of AF ablation program in our center. For CB ablation, a second generation 28 mm balloon was utilized and for RF ablation.

Results: A total of 100 consecutive patients (50 in each group) have been enrolled in the study (male 74%, mean age 58.9 ± 10 years, paroxysmal AF 85%). The mean procedure time was shorter for CB (116.6 ± 39.8 min) than RF group (191.8 ± 101.1 min) (p < 0.001). There was no difference in the mean fluoroscopy time, 24.2 ± 10.6 min in RF and 22.4 ± 11.7 min in CB group, (p = 0.422). Seven major complications occurred during the study; 5 in RF group (10%) and 2 in CB group (4%) (p = 0.436). After the mean follow up of 14.5 ± 2.4 months, 15 patients in RF group (30%) and 11 in CB group (26%) experienced AF recurrences (P = 0.300).

Conclusion: When starting a new AF ablation program, our results suggest that CB significantly shortens procedure while fluoroscopy time and clinical outcomes are comparable to RF ablation.

Keywords: Ablation; Atrial fibrillation; Contact force sensing radiofrequency catheters; Second generation cryoballoon.