Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Mapping & Imaging D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-189 - Different Characteristics After Radiofrequency And Cryo Ablations Based On Late Gadolinium Enhancement Magnetic Resonance Imaging (ID 1227)


Background: Radiofrequency ablation (RFCA) and cryoballoon ablation (CBA) are widely used to treat atrial fibrillation (AF) but the extent and time course of lesion formation and collateral damage associated with the two different modalities have not been assessed.
Objective: Our goal was to investigate the effectiveness and safety after ablation with the two modalities using serial late gadolinium enhancement cardiac magnetic resonance (LGE-CMR).
Methods: Patients who underwent AF ablation with RFCA (n = 50) or CBA (n = 51) and also experienced LGE-CMR scans, one within 24 hours (acute) another one after 90 days (chronic) following the ablation for assessment of esophageal injury and left atrial scar, respectively were included. Median follow-up period was 616 days [interquartile range: 377 to 978]. AF ablation failure was defined as any atrial tachyarrhythmia > 30 seconds after the 3-month blanking period.
Results: The median age and left ventricular ejection fraction of the patients was 65 [IQR 54.5, 71.5] years and 61.0 [55.0, 65.0] %, respectively (Panel A). Seventy five patients (74%) had paroxysmal AF and 26 (26%) had persistent AF. Acute lesion volume in RFCA group was significantly larger than that in CBA group but no difference was seen in chronic lesion volume. Acute esophageal enhancement was more frequently observed in RFCA group. Arrhythmia recurrence rate during blanking period showed no difference in the two groups. In addition, long term arrhythmia free survival was also similar (Panel B, Log-rank= 0.37).
Conclusion: RFCA resulted in more acute left atrial enhancement but had similar clinical outcomes. There was less acute esophageal enhancement seen in CBA.