Abstract 16568: Clinical Results of Cryoablation of Atrial Fibrillation Using the New Generation Cryoballoon Technology: First 6 Month Long Term Outcome Data
Background: Cryoballoon ablation recently has been established as a second standard ablation approach for nonpharmacological treatment of atrial fibrillation (Afib) besides point to point RF energy. Technological catheter improvement has been found in the recently released (09/2012) cryoballoon catheter system "Arctic Front Advance®" (AFA-CB; Medtronic). We compared its long term efficacy with the forerunner model Arctic front® (AF-CB; Medtronic). Different treatment protocols related to therapeutic freeze duration were used.
Methods: Fifty-six patients suffering from paroxysmal (PAF) or persistent (PEAF) Afib underwent a first ablation procedure using cryoablation. Treated either with AFA-CB or AF-CB 28 consecutive patients for each system has been enrolled. We used a single balloon catheter approach without touch up therapy with the settings: 300 seconds per freeze for AF-CB and 180 seconds for AFA-CB. The acute procedural success was assessed in all patients using an integrated inner lumen 8 (AFA-CB) or 6 (AF-CB) electrodes circular mapping catheter. The primary endpoints were both complete PV isolation (PVI) at the end of the ablation procedure, early Afib recurrence and long term outcome by assessing 3 month and 6month follow-up data.
Results: In the AFA-CB group (54% male, age 61±10 years), 46.6% had PEAF. In the AF-CB group (68% male, age 61 ±9 years), 32.1% had PEAF. Complete PVI (balloon catheter alone) was achieved in 25 (89%) of the AFA-CB patients vs. 17 (61%) of the AF-CB patients (P < 0.03). In addition, the ratio of isolated PV per patient was 3.9±0.3 and 3.5±0.7 for AFA-CB and AF-CB ablation, respectively (p<0.016). Early recurrence of Afib was observed less frequent (14%) in the AFA-CB group as compared to the AF-CB group (50%; p<0.009). At 6 months, treatment success was 89% of patients treated with AFA-CB and 64,3% of AF-CB patients (p <0,05) with 83,3% (AFA-CB group) and 50% (AF-CB group) of patients with freedom from Afib off all antiarrhythmic drugs, respectively.
Conclusion: Our data suggest a superiority of the new AFA-CB ablation system with shortened freezing protocol regarding acute procedural success as well as the recurrence rate of Afib during a follow-up of 6 month.
- © 2013 by American Heart Association, Inc.