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Ablation of paroxysmal atrial fibrillation using a second‐generation cryoballoon catheter or contact‐force sensing radiofrequency ablation catheter: A comparison of costs and long‐term clinical outcomes
Author(s) -
Yokokawa Miki,
Chugh Aman,
Latchamsetty Rakesh,
Ghanbari Hamid,
Crawford Thomas,
Jongnarangsin Krit,
Cunnane Ryan,
Saeed Mohammed,
Hornsby Kyle,
Krishnasamy Kavita,
Lohawijarn Watchara,
Keast Robert,
Karpenko David,
Bogun Frank,
Pelosi Frank,
Morady Fred,
Oral Hakan
Publication year - 2018
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13378
Subject(s) - medicine , pulmonary vein , atrial fibrillation , ablation , catheter , catheter ablation , radiofrequency ablation , paroxysmal atrial fibrillation , cardiology , surgery , anesthesia
Although noninferiority of cryoballoon ablation (CBA) and radiofrequency catheter ablation for antral pulmonary vein isolation (APVI) has been reported in patients with paroxysmal atrial fibrillation (PAF), it is not clear whether contact force sensing (CF‐RFA) and CBA with the second‐generation catheter have similar procedural costs and long‐term outcomes. The objective of this study is to compare the long‐term efficacy and cost implications of CBA and CF‐RFA in patients with PAF. Methods and results A first APVI was performed in 146 consecutive patients (age: 63 ± 10 years, men: 95 [65%], left atrial diameter: 42 ± 6 mm) with PAF using CBA (71) or CF‐RFA (75). Clinical outcomes and procedural costs were compared. The mean procedure time was significantly shorter with CBA than with CF‐RFA (98 ± 39 vs. 158 ± 47 minutes, P < 0.0001). Despite a higher equipment cost in the CBA than the CF‐RFA group, the total procedure cost was similar between the two groups (P = 0.26), primarily driven by a shorter procedure duration that resulted in a lower anesthesia cost. At 25 ± 5 months after a single ablation procedure, 51 patients (72%) in the CBA, and 55 patients (73%) in the CF‐RFA groups remained free from atrial arrhythmias without antiarrhythmic drug therapy (P = 0.84). Conclusions The procedure duration was approximately 60 minutes shorter with CBA than CF‐RFA. The procedural costs were similar with both approaches. At 2 years after a single procedure, CBA and CF‐RFA have similar single‐procedure efficacies of 72–73%.