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Cryoballoon catheter tied to fewer repeat ablations, lower hospitalization rates

Issue: September 2016

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Patients with paroxysmal atrial fibrillation who are treated with cryoballoon ablation experience fewer rehospitalizations, fewer repeat ablations and fewer direct current cardioversions than patients who were treated with radiofrequency ablation, researchers reported at Cardiostim–EHRA Europace 2016.

“The [findings] favor cryoballoon over [radiofrequency ablation], with important implications [for] daily clinical practice,” Karl-Heinz Kuck, MD, PhD, head of cardiology at St. Georg Hospital in Hamburg, Germany, said during a presentation of secondary analyses from the FIRE and ICE trial.

Karl-Heinz Kuck

The primary analysis of FIRE and ICE demonstrated that cryoballoon ablation (Arctic Front/Arctic Front Advance, Medtronic) guided by fluoroscopy was comparable in safety and effectiveness to radiofrequency ablation (ThermoCool/ThermoCool SF/ThermoCool SmartTouch catheters, Biosense Webster) guided by fluoroscopy and CARTO 3-D mapping.

Predefined secondary analyses included CV-related hospitalizations, repeat ablations and quality of life.

According to the results, the cryoballoon group (n = 221; mean age, 60 years; 59% men) experienced fewer CV-related hospitalizations (23.8% vs. 35.9%; P < .01) and 33% fewer repeat ablations (11.8% vs. 17.6%; P = .03) compared with the radiofrequency group (n = 236; mean age, 60 years; 63% men).

In addition, there were fewer all-cause hospitalizations (cryoballoon group, 32.6%; radiofrequency group, 41.5%; P = .01) and 50% fewer direct current cardioversions (3.2% vs. 6.4%; P = .04) in the cryoballoon group compared with the radiofrequency group.

Quality of life, assessed at baseline and again every 6 months for up to 30 months, was improved in both groups (P < .01 for mental and physical improvement in both groups), according to the researchers. – by Tracey Romero

Reference:

Kuck KH, et al. Late-Breaking Session. Presented at: Cardiostim–EHRA Europace 2016; June 8-11, 2016; Nice, France.

Disclosure: The study was funded by Medtronic. Kuck reports receiving consultant fees/honoraria from Biosense Webster, Edwards Lifesciences and St. Jude Medical and serving on the speakers’ bureau for Medtronic.