Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Cryoballoon Versus Radiofrequency Guided by Ablation Index for Atrial Fibrillation Ablation: A Retrospective Propensity-Matched Study
Session:
CO 13- Atrial fibrilation
Speaker:
Pedro Ribeiro Queirós
Congress:
CPC 2021
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Pedro Ribeiro Queirós; Gualter Silva; Mariana Ribeiro Da Silva; João Almeida; Paulo Fonseca; Diogo Ferreira; Fábio Sousa Nunes; Mariana Brandão; Rafael Teixeira; Marco Oliveira; Helena Gonçalves; Nuno Dias Ferreira; João Primo; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Background/Introduction:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"> Radiofrequency (RF) and cryoballoon (CB) ablation are established techniques for the treatment of atrial fibrillation (AF). Randomized trials comparing them show similar success; however, studies comparing CB with RF guided by ablation index (AI) are lacking. </span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Purpose: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">To compare treatment success of CB with RF guided by AI, in patients with paroxysmal or persistent AF undergoing their first ablation procedure. </span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Methods: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">Patients undergoing AF ablation between 2017 and 2019 were retrospectively analyzed. Primary success outcome was freedom from recurrence (defined as any episode of AF, atrial flutter or atrial tachycardia lasting >30 seconds and occurring after 91 days from ablation, or need for antiarrhythmic drugs (AAD), cardioversion or redo procedure). Secondary end-point was a composite of adverse cardiovascular (CV) outcomes (stroke/TIA, emergency room visit for AF, hospitalization for AF or CV death). Analysis was done before and after propensity score matching. </span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Results: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">A total of 316 patients were included. Mean age was 56.9±11.7 years. Sixty-two percent were male (n=196). Paroxysmal AF was present in 80.7% (n=255), with no difference between groups. RF was used in 57.9% (n=183) and CB in 42.1% (n=133), with isolation of all pulmonary veins accomplished in 95.9% (n=302), without differences between groups. Mean CHA</span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><sub>2</sub></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">DS</span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><sub>2</sub></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">-VASc score was 1.5±1.3, being higher in the RF group (1.7±1.3 vs 1.2±1.1; p=0.03); these patients were also older (mean age 58.1±12.0 vs. 55.17±11.0 years; p=0.07), more likely to be in AF at ablation (26.7% vs. 16.5%; p=0.006), have chronic kidney disease (40.2% vs. 23.2%; p=0.002), anaemia (11.8% vs. 2.7%; p<0.001), moderate/severe mitral disease (17.5% vs. 7.4%; p=0.012) or history of atrial flutter (17.7% vs. 3.1%; p<0.001). The CB group had longer history of AF (3.8±3.5 vs. 3.0±2.9 years; p=0.041), received treatment with AAD more often (60.9% vs. 55.9%; p=0.049) and had longer follow-up time (889±397 vs. 601±239 days; p<0.001). Mean freedom from recurrence showed no significant differences between groups (1106 days for CB vs. 889 days for RF; p=0.793), and recurrence rates were also similar (27.8% for CB vs. 23.5% for RF; p=0.291); however, CB patients were more likely to need a redo procedure (38.3% vs. 17.4%; p=0.025). There were no differences in the composite of adverse events or in individual outcomes. Propensity score matching was done, and 154 patients were matched 1:1 for each treatment group. Survival free from recurrence showed no differences (1060 days for CB vs. 864 days for RF; p=0.912), and neither did the recurrence rate. CB patients with recurrence were still more likely to need a redo procedure (37.9% vs. 11.1%; p=0.021). </span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Conclusion: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">RF and CB result in similar survival free from AF and AF recurrence; however, recurrence in CB seems more significant, leading to higher rates of redo procedures</span></span></span></p>
Video
Our mission: To reduce the burden of cardiovascular disease
Visit our site