Arrhythmias & electrophysiologySecondary analysis
Pulsed field or cryoballoon ablation for paroxysmal atrial fibrillation—insights from acute and chronic electroanatomic remapping in the randomized SINGLE-SHOT CHAMPION trial
- Prespecified substudy of the SINGLE SHOT CHAMPION randomised trial
- multicentre
Authors' conclusion
Fluoroscopy- and electrocardiogram-guided PVI can result in incomplete PV isolation after CBA or unintentional posterior wall block after PFA. In the acute mapping cohort, PFA yielded broader left-sided lesions than CBA; in a separate redo cohort, chronic PV durability was similar for both modalities.
Study context
- Population
- Patients with paroxysmal atrial fibrillation (AF) undergoing pulmonary-vein isolation (PVI); first 25 per group mapped by high-density 3D-EAM immediately after ablation
- Participants
- 25 vs 25
- Comparison
- Pulsed-field ablation (PFA) vs cryoballoon ablation (CBA) for PVI
- PFAn = 25
- CBAn = 25reference
Primary result
As reported in the abstract
CBA
16%
4 of 25
PFA
0
events
P = 0.11
Further findings
Left-sided antral lesion area <0.5 mV · immediately after ablation
P = 0.026
Posterior wall channel width · immediately after ablation
P < 0.001
Durable PVI at clinically indicated redo (n = 48) · repeat ablation · veins
P = 0.88
Durable veins PFA 63/102 (62%) · CBA 52/82 (63%)
- Durable PVI at clinically indicated redo (n = 48): patients: 4/26 PFA, 3/22 CBA
Safety
| Outcome | PFA | CBA |
|---|---|---|
| Inadvertent posterior wall conduction block · immediately after ablation | 12% | Not reported in the abstract |
- Inadvertent posterior wall conduction block: patients with small atria (mean LA volume 30.7 mL)
Original publication
Summarised from the published abstract; every number is checked against it