Arrhythmias & electrophysiology
Impact of alternative efficacy end point definitions on reported outcomes after ablation of paroxysmal atrial fibrillation – Insights from the COMPARE-CRYO study using continuous rhythm monitoring
Authors' conclusion
Alternative efficacy end point definitions have a significant impact on reported outcomes and health care utilization metrics after AF ablation. These findings are important when considering end point definitions other than the traditional 30 seconds in the design of future AF-ablation trials.
Study context
- Population
- Patients with paroxysmal atrial fibrillation (AF) undergoing cryoballoon ablation
- Participants
- 201 patients
- Comparison
- Alternative efficacy end point definitions based on AF-burden, duration or number of episodes vs any atrial arrhythmia lasting ≥30 seconds
- Primary endpoint
- Any recurrence lasting ≥30 seconds
- Follow-up
- 91-365 days
Methodological detailsimplantable cardiac monitors (ICM), blanking period was 90 days
- Implantable cardiac monitors (ICM)
- Blanking period was 90 days
Primary result
As reported in the abstract
Recurrence
89 of 201 patients
44%
Further findings
One-year success rates by arrhythmia duration threshold
- ≥30 sec
- 56%
- ≥24 hrs
- 97%
One-year success rates by number of episode threshold
- ≥1 episode
- 56%
- ≥100 episodes
- 98%
One-year success rates by AF-burden threshold
- AF-burden >0%
- 56%
- AF-burden >2%
- 93%
Redo ablations and AF-related hospitalizations
- Rates increased for AF-episode durations >1 hour, >6 AF-episodes, and an AF-burden >0.1%
- Rates highest for AF-episode durations >24 hours, >33 AF-episodes, and an AF-burden >1%
Original publication
Impact of alternative efficacy end point definitions on reported outcomes after ablation of paroxysmal atrial fibrillation – Insights from the COMPARE-CRYO study using continuous rhythm monitoring. Heart Rhythm. Published 19 September 2025. doi:10.
Summarised from the published abstract; every number is checked against it