Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-126 - Propensity-matched Comparison Of Hotballoon And Cryoballoon Ablation In Patients With Persistent Atrial Fibrillation (ID 1113)


Background: The clinical efficacy and safety of hotballoon ablation (HBA) in patients with paroxysmal atrial fibrillation (AF) have been reported, however, that for patients with persistent AF (PEF) remains unclear.
Objective: We aimed to evaluate the clinical efficacy and safety of HBA compared to cryoballoon ablation (CBA) in PEF patients.
Methods: This study included in 195 consecutive patients who underwent HBA and CBA for short-lasting PEF (<1 year). The data were compared between HBA and CBA in 79 propensity score-matched pairs of patients. All patients who underwent HBA received an additional upper antral ablation with a larger balloon size in addition to a single-shot for each PV ostial ablation, while for CBA they underwent a simple single-shot protocol.
Results: Touch-up radiofrequency ablation was required to complete the PVI in 38 (48%) HBA and 33 (42%) CBA patients (P=0.42), respectively. A proportion of the posterior wall ablation areas were significantly larger after the HBA than CBA (52±14% vs. 43±14%, P=0.0002, Fig A). At the 1-year follow up, the freedom from AF recurrence rate was 96% for HBA and 89% for CBA (P=0.43, Fig B), while taking antiarrhythmic drugs in 40 (51%) HBA and 47 (59%) CBA patients (P=0.26), respectively. There was no significant difference in serious complications between HBA and CBA (3 [4%] vs. 1 [1%], P=0.62); 1 pericardial tamponade, 1 pericarditis, and 1 aspiration pneumonia occurred after HBA and 1 phrenic nerve paralysis after CBA.
Conclusion: While the procedural protocol and lesion characteristics differed for each balloon system, HBA and CBA were comparable regarding their efficacy and safety in patients with PEF.