Non-fluoroscopic approach to cryoballoon ablation for atrial fibrillation. (1 year follow-up results)

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OBJECTIVE

To evaluate the efficacy and safety of cryoballoon ablation of pulmonary veins without fluoroscopy compared to standard technique.

MATERIAL AND METHODS

The study included 110 patients with symptomatic paroxysmal and persistent AF without previous RFA attempts. Patients were divided into two equal groups: group A — 55 patients undergoing cryoballoon ablation with 3D navigation mapping (EnSite Precision) and intracardiac echocardiography (ICE); group B — 55 patients undergoing standard fluoroscopy-assisted cryoballoon ablation. Throughout 12-month follow-up period, we analyzed freedom from heart rhythm disturbances considering survey data and results of ECG and 24-hour ECG monitoring.

RESULTS

After 6 months, recurrent arrhythmias developed in 12 (21.8%) patients of the group A and 10 (18.2%) ones of the group B (p=0.81). After 12 months, stable sinus rhythm was observed in 67.3% of patients in the group A and 70.9% of patients in the group B (p=0.83).

Fluoroscopy time (0.9±0.4 versus 14.1±2.67 min) and irradiation dose (8.75±1.7 versus 184.5±28.6 mGy) were significantly higher in the group B (p<0.001). Mean time of cryoballoon ablation was similar in both groups (86.3±19.1 versus 79.8±19.8 min, p=0.11). Morbidity rate was also similar.

CONCLUSION

Efficiency of cryoballoon ablation of pulmonary veins without fluoroscopy is not inferior to standard fluoroscopy-assisted ablation. Positive results with irradiation dose reduction were achieved without compromising the patient safety.

Keywords:

atrial fibrillation

cryoballoon ablation

intracardiac echocardiography

non-fluoroscopic approach

X-ray irradiation

Authors:

Kostin V.S.

National Medical Research Center of Cardiology

Sapelnikov O.V.

ORCID: 0000-0002-5186-2474

Uskach T.M.

ORCID: 0000-0003-4318-0315

Cherkashin D.I.

ORCID: 0000-0003-1679-1719

Grishin I.R.

ORCID: 0000-0001-5839-1858

Kulikov A.A.

Russian Cardiology Research Center

Gusejnli E.G.

ORCID: 0000-0002-6726-4612

Vereshchagina A.V.

National Medical Research Center of Cardiology

Ardus D.F.

ORCID: 0000-0001-8305-1855

Akchurin R.S.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-2105-8258

Received:

24.09.2021

Accepted:

10.11.2021

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