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A Comparison of cryoballoon and Radiofrequency ablation as redo procedure-ablation in Patients with recurrent Atrial fibrillation after cryoballoon-ablation
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  • Wasim Schehab,
  • Markus Schlömicher,
  • Gresa Kciku,
  • Snehasis Pradhan,
  • Hans J. Trappe,
  • Justus Strauch
Wasim Schehab
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Markus Schlömicher
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Gresa Kciku
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Snehasis Pradhan
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Hans J. Trappe
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Justus Strauch
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Abstract

Background: A significant proportion of patients with recurrent [atrial fibrillation](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/atrial-fibrillation) (AF) require repeat [radiofrequency](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/radiofrequency) (RFC) or cryoballoon (CB) ablation after the blanket period (90 days) following the initial cryoablation. However, little is known about the efficacy of pulmonary vein isolation using either of the technique as a redo procedure. Therefore, the present study aimed to analyze the electrophysiological characteristics of pulmonaary veins (PVs) during redo ablation procedures and clinical outcomes in patients undergoing CB-vs-RFC ablation as redo procedures. Methods: 61 Patients with paroxysmal and persistent atrial fibrillation were retrospectively included in the analysis. The number and location of reconnected PVs, another arrhythmic drug before the reablation, structural heart disease and antiarrhythmic drugs were determined. Results: Before the redo procedure, paroxysmal atrial fibrillation was the predominant recurrent arrhythmia (60%). However,20 patients (70%) had paroxysmal atrial fibrillation in the RFC and 16 Patients (50%) in the CB group 29 Patients (47,5%) underwent a catheter ablation with radiofrequency, and 32 Patients (50,8%) underwent a catheter ablation with a cryoballoon. The Median of reablation occurred of 238 and 323 days (P= 0,0008). The Number of the reconnected PVs was 42 in the RFC group and was 99 in the CB group, which means the number of lesions applied during the redo Procedure was significantly greater in the CB cohort. The reconnection was driven by more reconnection in the left superior PV. After Reablation, there were no differences in the antiarrhythmic drug between the cohorts, but significantly more patients required amiodarone in the RFC Cohort. Conclusion: This analysis revealed an overall success rate of 70% in patients with recurrent atrial fibrillation who underwent a redo treatment using either radiofrequency or cryoballoon, implying equivalent performance effectiveness between both modalities.