SPC365

Initial experience of atrial fibrillation catheter ablation in a low-volume center: cryoablation vs radiofrequency

Session: Posters (Sessão 6 - Écran 3) - Arrítmias 7 - Fibrilhação Auricular 2
Speaker: Pedro Campos Amador

Congress: CPC 2022
Topic: C. Arrhythmias and Device Therapy
Theme: 05. Atrial Fibrillation
Subtheme: 05.4 Atrial Fibrillation - Treatment
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Pedro Campos Amador; Leonor Parreira; Rui Antunes Coelho; Dinis Mesquita; Rita Marinheiro; Alexandra Gonçalves; Duarte Chambel; Maria João Lopes; Tânia Teixeira; Pedro Contreiras; Dina Ferreira; Rui Caria

<p><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,&quot;sans-serif&quot;"><strong><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">Background:&nbsp;</span></span></strong><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">Atrial fibrillation (AF) catheter ablation is increasingly being performed worldwide, nevertheless there are concerns of lower success rates and higher complications of AF ablations performed in low-volume centers. Cryoablation (CRYO) is accepted as a technique with a faster learning curve, so usually suggested as the procedure of choice for those centers. &nbsp;Thus, we sought to evaluate the safety and efficacy of AF catheter ablation during the learning curve for the two different &nbsp;technologies: radiofrequency (RF) and CRYO in a low-volume center.</span></span></span></span></span></p>

<p><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,&quot;sans-serif&quot;"><strong><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">Methods and results:&nbsp;</span></span></strong></span></span></span><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,&quot;sans-serif&quot;"><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">We studied the first 25 patients with paroxysmal AF that underwent catheter ablation with each technique at our center. We evaluated the procedure time, fluoroscopy time, major complications and outcomes. Primary outcome was AF recurrence rate. Secondary outcomes included periprocedural complications, hospitalization for symptomatic tachy-arrhythmias post-ablation and number of repeat ablations. </span></span></span></span></span></p>

<p><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,&quot;sans-serif&quot;"><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">Mean age of our cohort was 64.0 &plusmn; 9.1 years, of which 22 (44%) were males. Baseline characteristics of both groups were not significantly different (Table 1).</span></span></span></span></span></p>

<p><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,&quot;sans-serif&quot;"><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">Procedure times were significantly longer for RF (193.8 &plusmn; 48.7 min vs 120.8 &plusmn; 17.6 min , p&lt;0.001; graph 1A) and fluoroscopy times were also longer (20.5 &plusmn; 5.8 min vs x &plusmn; 15.1 &plusmn; 3.8 min, p = 0.02, graph 1B). </span></span></span></span></span></p>

<p><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,&quot;sans-serif&quot;"><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">Survival free from AF was not significantly different between the 2 groups (HR 0,47 -95% CI 0.14-1.61, p=0.231) &ndash; graph 1C.</span></span></span></span></span></p>

<p><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,&quot;sans-serif&quot;"><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">There were no significant differences in secondary outcomes. </span></span></span></span></span></p>

<p><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,&quot;sans-serif&quot;"><strong><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">Conclusions: </span></span></strong><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">Starting<strong> </strong>of AF </span></span><span style="font-family:&quot;Segoe UI&quot;,&quot;sans-serif&quot;"><span style="color:#212121">ablation at low volume centers is feasible with comparable efficacy and safety outcomes to high-volume centers using contemporary ablation technologies. In our group of patients procedure and fluoroscopy times with RF were longer but both techniques achieved comparable results.</span></span></span></span></span></p>