Arrhythmias & electrophysiologyRandomised controlled trial
HIgh Power short duration radiofrequency ablation or cryoballoon ablation for paroxysmal Atrial Fibrillation (HIPAF trial)
- Randomised controlled trial
- non-inferiority
Authors' conclusion
In this randomized non-inferiority trial comparing vHPSD RFA to CBA for PVI in patients with PAF, non-inferiority of vHPSD RFA could not be shown. Both methods showed comparable safety outcome with a shorter procedure time for CBA.
Study context
- Population
- Patients with symptomatic paroxysmal AF undergoing de novo pulmonary vein isolation (PVI)
- Participants
- 170 patients
- Comparison
- Very high-power short-duration (vHPSD) radiofrequency ablation (RFA) vs cryoballoon ablation for de novo PVI
- vHPSDn = 84
- Cryoballoon ablation (CBA)n = 86reference
- Primary endpoint
- Composite of:
- Any atrial arrhythmia
- New antiarrhythmic drug onset
- Re-ablation
- Follow-up
- 1 year after index procedure
Primary result
Freedom from any event · median follow-up 367 days
Difference
−0.076
95% CI −0.201 to 0.049
Events by treatment group
vHPSD vs CBA
difference −0.076 (95% CI −0.201 to 0.049)
Non-inferiority margin 10 as printed, not drawn
As reported in the abstract
Further findings
Procedure time
P < 0.001
Ablation time
P = 0.285
Fluoroscopy time
P = 0.031
Contrast medium
P < 0.001
Safety
| Outcome | vHPSD | CBA |
|---|---|---|
| Complications | ||
| Pulmonary vein stenosis | 1 | Not reported in the abstract |
| Pericardial effusion | Not reported in the abstract | 3 |
| TIA | Not reported in the abstract | 2 |
Complications
- Complication rates comparable between groups
Original publication
HIgh Power short duration radiofrequency ablation or cryoballoon ablation for paroxysmal Atrial Fibrillation (HIPAF trial). Europace. Published 31 March 2025. doi:10.1093/europace/euaf066
Summarised from the published abstract; every number is checked against it