Author + information
- Dursun Aras1,
- Serkan Topaloğlu1,
- Serkan Çay1,
- Fırat Özcan1,
- Fatih Uçar1,
- Özcan Özeke1,
- Osman Turak1 and
- Göksel Çağırcı2
Cryoballoon ablation of atrial fibrillation (AF) is an effective therapy in maintaining sinus rhythm. The procedure is mainly recommended for anti-arrhythmic resistant cases. No randomized study is, however, present about cryoablation as first line therapy.
The aim is to compare cryoablation as first line therapy with cryoablation after drug resistance.
Consecutive patients (all-comers) with paroxysmal AF (PAF) planned for catheter ablation were randomized to cryoballoon (Arctic Front Advance, Medtronic) ablation as first-line therapy without prior anti-arrhythmic drug use (n=33) and cryoballoon (Arctic Front Advance, Medtronic) ablation after at least one anti-arrhythmic drug resistance (n=23). All patients were followed-up at least 12 months. Periodic ambulatory Holter monitoring was performed to detect any recurrence at 1, 3, 6, 9, 12, and every 6 months after 1 year.
The median age was 49 years. Male was 66% and 7% of patients had diabetes and 34% had hypertension. The mean follow-up period was 18±5 months and the mean procedural time was 59±8 minutes. The primary end-point of freedom from AF was found to be statistically indifferent in both groups (78.8% for first-line therapy vs. 78.3% for after-drug therapy, p=0.857) (figure).
Cryoballoon ablation as first-line therapy is as effective as cryoballoon ablation after anti-arrhythmic drug resistance in maintaining sinus rhythm.