TY - JOUR
TI - 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)
AU - Giannopoulos, G.
AU - Kossyvakis, C.
AU - Vrachatis, D.
AU - Aggeli, C.
AU - Tsitsinakis, G.
AU - Letsas, K.
AU - Tsiachris, D.
AU - Tsoukala, S.
AU - Efremidis, M.
AU - Katritsis, D.
AU - Deftereos, S.
JO - Journal of Cardiovascular Electrophysiology
PY - 2019
VL - 30
TODO - 7
SP - 991-998
PB - Blackwell Publishing Inc.
SN - 1045-3873, 1540-8167
TODO - 10.1111/jce.13933
TODO - 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
TODO - 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.
ER -