TY - JOUR

T1 - Concomitant ablation for non-paroxysmal atrial fibrillation: combined energy versus cryoablation alone

AU - Tsaroev, Bashir

AU - Sharifulin, Ravil

AU - Afanasyev, Alexander

AU - Khrushchev, Sergey

AU - Murtazaliev, Murtazali

AU - Lovtsova, Darya

AU - Kashapov, Robert

AU - Ruzankin, Pavel

AU - Mustaev, Muslim

AU - Bogachev-Prokophiev, Alexander

N1 - The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The research was carried out within the state assignment of Ministry of Health of Russian Federation (theme No 124022000090-0). Statistical analysis was performed by Khrushchev S. and Ruzankin P., and their participation was supported by the Program for fundamental scientific research of the Siberian Branch of the Russian Academy of Sciences [project number FWNF-2024-0001]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

PY - 2024/10/17

Y1 - 2024/10/17

N2 - Background: Surgical ablation of atrial fibrillation has been the most efficient treatment for atrial fibrillation (AF). Combined energy (CE) ablation and cryoablation alone (CA) are the most common energy modes used for ablation, however, comparative data is lacking. Objectives: To compare the efficacy of CE ablation with CA in the setting of concomitant biatrial ablation for non-paroxysmal AF. Methods: A retrospective analysis of 453 patients with non-paroxysmal AF undergone concomitant biatrial ablation from November 2007 to December 2022 during elective cardiac surgery using either combined bipolar radiofrequency with cryoenergy or cryoenergy alone was performed. Propensity score matching was conducted to balance the covariates in the groups. Results: There were 157 patients per group after matching. CE ablation was associated with lower odds of atrial tachyarrhythmia recurrence (OR = 0.13, 95% CI 0.02–0.91, p = 0.040), a significantly lower rate of hospital readmissions due to rhythm disruption (HR = 0.34, 95% CI 0.18–0.65, p < 0.001), and lower cumulative incidence of stroke (SHR = 0.38, 95% CI 0.15–0.97, p = 0.043). No significant difference in permanent pacemaker implantation was observed between the two groups. Conclusions: In the setting of concomitant biatrial ablation for non-paroxysmal AF, combined bipolar radiofrequency and cryoablation appear to be a superior treatment modality compared to cryoablation alone in achieving long-term freedom from atrial arrhythmias, in reducing arrhythmia-related hospital readmissions and ischemic strokes.

AB - Background: Surgical ablation of atrial fibrillation has been the most efficient treatment for atrial fibrillation (AF). Combined energy (CE) ablation and cryoablation alone (CA) are the most common energy modes used for ablation, however, comparative data is lacking. Objectives: To compare the efficacy of CE ablation with CA in the setting of concomitant biatrial ablation for non-paroxysmal AF. Methods: A retrospective analysis of 453 patients with non-paroxysmal AF undergone concomitant biatrial ablation from November 2007 to December 2022 during elective cardiac surgery using either combined bipolar radiofrequency with cryoenergy or cryoenergy alone was performed. Propensity score matching was conducted to balance the covariates in the groups. Results: There were 157 patients per group after matching. CE ablation was associated with lower odds of atrial tachyarrhythmia recurrence (OR = 0.13, 95% CI 0.02–0.91, p = 0.040), a significantly lower rate of hospital readmissions due to rhythm disruption (HR = 0.34, 95% CI 0.18–0.65, p < 0.001), and lower cumulative incidence of stroke (SHR = 0.38, 95% CI 0.15–0.97, p = 0.043). No significant difference in permanent pacemaker implantation was observed between the two groups. Conclusions: In the setting of concomitant biatrial ablation for non-paroxysmal AF, combined bipolar radiofrequency and cryoablation appear to be a superior treatment modality compared to cryoablation alone in achieving long-term freedom from atrial arrhythmias, in reducing arrhythmia-related hospital readmissions and ischemic strokes.

KW - atrial fibrillation

KW - biatrial ablation

KW - concomitant ablation

KW - cryoablation

KW - maze procedure

KW - radiofrequency ablation

UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85205358239&origin=inward&txGid=34639df8537d605e6b2f885c032bc55b

UR - https://elibrary.ru/item.asp?id=74428108

UR - https://www.webofscience.com/wos/woscc/full-record/WOS:001330291700001

UR - https://www.mendeley.com/catalogue/a2bc4ef1-9319-3c86-add4-373ffd9d2e11/

U2 - 10.3389/fcvm.2024.1448523

DO - 10.3389/fcvm.2024.1448523

M3 - Article

VL - 11

SP - 1448523

JO - Frontiers in cardiovascular medicine

JF - Frontiers in cardiovascular medicine

SN - 2297-055X

ER -