Arrhythmias & electrophysiologyCohort study
Pulsed electric field, cryoballoon, and radiofrequency for paroxysmal atrial fibrillation ablation: a propensity score-matched comparison
- Retrospective cohort study
- propensity-score matched
- multicentre
Authors' conclusion
Pulsed field ablation contributed to significantly shorter procedural times. Follow-up data showed a similar arrhythmia freedom, although a higher rate of PV reconnection was documented in post-CRYO and post-RF redo procedures.
Study context
- Population
- Paroxysmal AF patients undergoing first-time pulmonary vein isolation (PVI)-only ablationmatched cohort 174:348:348
- Participants
- 1,572 patients
- Exposure
- Pulsed field ablation (PFA) vs CRYO vs RF for PVI
- PFAn = 174
- CRYOn = 348
- RFn = 348
Main finding
As reported in the abstract
First-pass PV isolation
Observational data: associations, not effects.
Further findings
Freedom from any atrial tachyarrhythmia (Kaplan-Meier) · 1 year
PV reconnection at repeat ablation (145 procedures)
- Freedom from any atrial tachyarrhythmia (Kaplan-Meier): log-rank P-value: 0.24
- PV reconnection at repeat ablation (145 procedures): P = 0.01
Procedural and dwell times; X-ray exposure
- Procedural and dwell times significantly shorter with PFA
- Significant reduction in X-ray exposure with RF (3D mapping)
Safety
Overall complications
- Overall complications: P = 0.052
Original publication
Pulsed electric field, cryoballoon, and radiofrequency for paroxysmal atrial fibrillation ablation: a propensity score-matched comparison. Europace. Published 20 January 2024. doi:10.1093/europace/euae016
Summarised from the published abstract; every number is checked against it