Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques
D-PO02 - Poster Session II (ID 47)
Poster
D-PO02-167 - Characteristics Of Atrial Fibrillation Ablation Procedures Using Cryoballoon Versus Radiofrequency Ablation: A Report From The GWTG-AFIB Registry (ID 1040)
Abstract
Background: Cryoballoon ablation (CBA) is an alternative to radiofrequency ablation (RFA) for catheter ablation of atrial fibrillation (AF).
Objective: To compare patient and periprocedural characteristics of CBA vs. RFA procedures reported to the Get With the Guidelines AFIB Registry.
Methods: Categorical variables were compared via the Χ2 test and continuous variables were compared via the Wilcoxon rank sum test.
Results: A total of 5247 (1465 CBA, 3782 RFA) cases were reported from 33 sites. Those undergoing CBA more often had paroxysmal AF (60.1 vs. 49.6%) and no prior AF ablation (12.5 vs. 26.2%). CHA2DS2-VASc scores were similar. Among de novo ablations, (CBA 1282, RFA 2792) conscious sedation was more common with CBA (15.6 vs. 2.8%, p<.001) but general anesthesia was most common. Intraprocedural TEE was more common with CBA (8.7 vs. 3.2%, p<.001). Most ablations involved intracardiac echocardiography and electroanatomic mapping, but both were less common with CBA (87.3 vs.93.9%, p<.001, and 87.7 vs. 94.6%, p<.001, respectively). CBA was associated with shorter procedures (129 vs. 179 min, <.001), increased fluoroscopy use (19 vs. 11 min, p<.001), and similar ablation times (27 vs. 35 min, p=.15). Non-pulmonary vein ablation was common with CBA: roof line 38.6%, floor line 20.4%, cavotricuspid isthmus 27.7%. RFA was associated with more total complications compared to CBA (5.4 vs. 2.3%, p<.001), due to more volume overload and “other” events (Table). Phrenic nerve injury was more common with CBA.
Conclusion: Periprocedural technology use, procedure duration, fluoroscopy use, and complications vary based on CBA vs. RFA. In US practice, non-pulmonary vein ablation was common with CBA.
Collapse
Objective: To compare patient and periprocedural characteristics of CBA vs. RFA procedures reported to the Get With the Guidelines AFIB Registry.
Methods: Categorical variables were compared via the Χ2 test and continuous variables were compared via the Wilcoxon rank sum test.
Results: A total of 5247 (1465 CBA, 3782 RFA) cases were reported from 33 sites. Those undergoing CBA more often had paroxysmal AF (60.1 vs. 49.6%) and no prior AF ablation (12.5 vs. 26.2%). CHA2DS2-VASc scores were similar. Among de novo ablations, (CBA 1282, RFA 2792) conscious sedation was more common with CBA (15.6 vs. 2.8%, p<.001) but general anesthesia was most common. Intraprocedural TEE was more common with CBA (8.7 vs. 3.2%, p<.001). Most ablations involved intracardiac echocardiography and electroanatomic mapping, but both were less common with CBA (87.3 vs.93.9%, p<.001, and 87.7 vs. 94.6%, p<.001, respectively). CBA was associated with shorter procedures (129 vs. 179 min, <.001), increased fluoroscopy use (19 vs. 11 min, p<.001), and similar ablation times (27 vs. 35 min, p=.15). Non-pulmonary vein ablation was common with CBA: roof line 38.6%, floor line 20.4%, cavotricuspid isthmus 27.7%. RFA was associated with more total complications compared to CBA (5.4 vs. 2.3%, p<.001), due to more volume overload and “other” events (Table). Phrenic nerve injury was more common with CBA.
Conclusion: Periprocedural technology use, procedure duration, fluoroscopy use, and complications vary based on CBA vs. RFA. In US practice, non-pulmonary vein ablation was common with CBA.
