@article{3122198,
    title = "Effect of cryoballoon and radiofrequency ablation for pulmonary vein isolation on left atrial function in patients with nonvalvular paroxysmal atrial fibrillation: A prospective randomized study (Cryo-LAEF study)",
    author = "Giannopoulos, G. and Kossyvakis, C. and Vrachatis, D. and Aggeli, C. and Tsitsinakis, G. and Letsas, K. and Tsiachris, D. and Tsoukala, S. and Efremidis, M. and Katritsis, D. and Deftereos, S.",
    journal = "Journal of Cardiovascular Electrophysiology",
    year = "2019",
    volume = "30",
    number = "7",
    pages = "991-998",
    publisher = "Blackwell Publishing Inc.",
    issn = "1045-3873, 1540-8167",
    doi = "10.1111/jce.13933",
    keywords = "adult;  aged;  Article;  controlled study;  cryoablation;  echocardiography;  echography;  female;  heart ejection fraction;  heart left atrium;  human;  left atrial ejection fraction;  major clinical study;  male;  middle aged;  paroxysmal atrial fibrillation;  postoperative period;  priority journal;  prospective study;  pulmonary vein isolation;  radiofrequency ablation;  randomized controlled trial;  recurrent disease;  therapy effect;  three dimensional echocardiography;  treatment outcome;  action potential;  adverse event;  atrial fibrillation;  catheter ablation;  clinical trial;  comparative study;  convalescence;  cryosurgery;  diagnostic imaging;  Greece;  heart atrium function;  heart rate;  multicenter study;  pathophysiology;  pulmonary vein;  time factor, Action Potentials;  Aged;  Atrial Fibrillation;  Atrial Function, Left;  Catheter Ablation;  Cryosurgery;  Echocardiography, Three-Dimensional;  Female;  Greece;  Heart Rate;  Humans;  Male;  Middle Aged;  Prospective Studies;  Pulmonary Veins;  Recovery of Function;  Recurrence;  Time Factors;  Treatment Outcome",
    abstract = "Background: Isolation of the pulmonary veins (PVI) has become a mainstay in atrial fibrillation (AFib) therapy. Lesions in left atrial tissue lead to scar formation and this may affect left atrial function. Methods: Patients with paroxysmal AFib were randomly assigned in a 1:2 allocation scheme to radiofrequency (RF) ablation or cryoballoon. Real-time three-dimensional echocardiography was performed (under sinus rhythm in all cases) before ablation and at 1 and 3 months to evaluate the left atrial functional indices. The primary outcome measure was change in left atrial ejection fraction (LAEF) at 1 month. Results: 120 patients were randomized (80 to cryoballoon, 40 to RF). The absolute change in LAEF at 1 month was 4.0 (Q1-Q3, −0.1to 7.6)% in the cryoballoon group and −0.8 (Q1-Q3, −1.9 to 0.9)% in the RF group (P < 0.001 for the comparison between groups). At 3 months, the corresponding changes were 6.7 (Q1-Q3, 3.4-11.2)% and 0.7 (Q1-Q3, −0.7 to 3.5)%, respectively (P < 0.001). Overall, the rate of patients with lower LAEF at 3 months compared to baseline was 2.5% in the cryoballoon group and 32.5% in the RF group (P < 0.001). AFib recurrence rate at 6 months was higher in patients with decreased LAEF (odds ratio, 6.2; 95% confidence interval, 2.0-19.5; P = 0.002). Conclusion: The Cryo-LAEF study prospectively compared the effects of RF and cryoballoon ablation on left atrial function. Both at 1 and 3 months postablation, LAEF was either improved or stable in both ablation groups. © 2019 Wiley Periodicals, Inc."
}