Τίτλος:
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)
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Giannopoulos, G.
Kossyvakis, C.
Vrachatis, D.
Aggeli, C.
Tsitsinakis, G.
Letsas, K.
Tsiachris, D.
Tsoukala, S.
Efremidis, M.
Katritsis, D.
Deftereos, S.
Περιοδικό:
Journal of Cardiovascular Electrophysiology
Εκδότης:
Blackwell Publishing Inc.
Λέξεις-κλειδιά:
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
