Comparison Between Radiofrequency Catheter Ablation And Cryoballoon Ablation For Paroxysmal Atrial Fibrillation And The Risk Factors

Background:Currently radiofrequency catheter ablation(RFCA)and cryoballoon ablation(CBA)are the two standard ablation systems used for catheter ablation of atrial fibrillation;However,there are few data comparing these modalities for treatment of paroxysmal AF(pAF)in the Chinese population.The purpose of this study was to compare the recurrance of CBA against RFCA and analysis the risk factors of AF recurrance after ablation.Methods:A single-center cohort study evaluated patients who underwent catheter ablation for pAF using RFCA or CBA between January 1,2014 and June 31,2016.Patients with prior ablation and those without rhythm follow-up for at least 3 months were excluded.The primary end point was freedom from AF,atrial flutter,and atrial tachycardia(FFAF)>30 seconds after a 3-month blanking period without requirement for antiarrhythmic drugs.Results:A total of 399 patients were included(RFCA = 203,CBA = 196).The mean duration of follow-up was15.0 monthes(median 12.3 monthes,interquartile range 8.8-19.7monthes,maximum 33 months,minimum 3 months).The primary end point occurred in 69 in the RFCA group and 54 in the CBA group.In multivariable models adjusted for age,gender,the medical history of palpitation time,BMI>25 kg/m2,hypertention,LAD and the difference of ablation procedure(RFCA or CBA),cryoballoon ablation was noninferior to radiofrequency ablation with respect to efficacy for the treatment of patients with drug-refractory paroxysmal atrial fibrillation.And the risk foctors related to the recurrance of AF after ablation included,hypertention(HR=1.550;P=0.022;95%CI:1.065-2.257),the medical history of palpitation time(HR= 1.005;P<0.001;95%CI:1.002-1.007),BMI>25 kg/m2(HR=1.667;P=0.007;95%CI:1.153-2.411)and LAD(HR=1.042;P=0.032;95%CI:1.003-1.083).Conclusion:This study demonstrates noninferiority of RFCA versus CBA for treating patients with paroxysmal atrial fibrillation.The independent risk factors for the recurrance of AF after ablation include hypertention,BMI>25kg/m2,the long medical history of palpitation and LAD.