Radiofrequency versus cryoballoon ablation for atrial fibrillation in the setting of left common pulmonary veins

• DOI: 10.1111/pace.13810
• Publication Date: 2019-10-03T12:11:19Z
• Authors: Hugo‐Enrique Coutiño; Erwin Ströker; Ken Takarada; Giacomo Mugnai; Juan‐Pablo Abugattas; Juan Sieira; Francesca Salghetti; Muryo Terasawa; Varnavas Varnavas; Riccardo Maj; Thiago Guimarães ...; Diego Neach; Pedro Brugada; Carlo de Asmundis; Gian‐Battista Chi...
• Keywords: Male; left common pulmonary veins; Anatomic Variation; Second-generation cryoballoon; Middle Aged; Pulmonary vein isolation; Cryosurgery; 03 medical and health sciences; 0302 clinical medicine; Pulmonary Veins; Atrial Fibrillation; RADIOFREQUENCY; Catheter Ablation; Humans; Female; Aged

Abstract Background A left common pulmonary vein (LCPV) accounts as the most frequent (PV) variation. Our aim was to compare performance of radiofrequency (RF) versus second‐generation cryoballoon (CB‐A) ablation in patients with atrial fibrillation (AF) and LCPVs. Methods In a total cohort 716 undergoing PV isolation preprocedural CT‐scanning, LCPV+ were selected measurement ostial area trunk distance. All matched between RF CB‐A group 1:1 ratio based on propensity scores, compared for outcome. Results Left veins found 31% (88/283) 34% (146/433) patients, respectively, ( P = .44). population 83 each group, electrical could be achieved all left‐sided PVs. No significant difference noted rate AF/left tachyarrhythmia (LAT) recurrence (30% vs 28%, .86), similar AF/LAT‐free survival (log rank, .71). There 48 AF/LAT (29%) during follow‐up. Recurrence paroxysmal persistent AF 27/120 (22.5%) 21/46 (46%), .004. Cox proportional regression analysis withheld LA volume independent variables predict recurrence. increased hazard observed long (>15 mm) short (5‐15 LCPV (OR 1.14, 95% CI 0.6‐2.2, .7). Conclusions our study, equal efficacy outcome technology.