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

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

Journal

Frontiers in Cardiovascular Medicine
, E-ISSN: 2297-055X

Output data

Year: 2024, Volume: 11, Article number : 1448523, Pages count : 9 DOI: 10.3389/fcvm.2024.1448523

Tags

atrial f ibrillation, maze procedure, biatrial ablation, concomitant ablation, radiofrequency ablation, cryoablation

Authors

Tsaroev Bashir ¹ , Sharifulin Ravil ¹ , Afanasyev Alexander ¹ , Khrushchev Sergey ^2,3 , Murtazaliev Murtazali ¹ , Lovtsova Darya ¹ , Kashapov Robert ¹ , Ruzankin Pavel ^2,3 , Mustaev Muslim ⁴ , Bogachev-Prokophiev Alexander ¹

Affiliations

1	Department of Adult Cardiac Surgery, E.N. Meshalkin National Medical Research Center, Novosibirsk, Russia.
2	Department of Mathematics and Mechanics, Novosibirsk State University, Novosibirsk, Russia.
3	Laboratory of Applied Inverse Problems, Sobolev Institute of Mathematics, Novosibirsk, Russia.
4	Department of Adult Cardiac Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

Funding (2)

1	Sobolev Institute of Mathematics	FWNF-2024-0001
2	Министерство здравоохранения РФ	124022000090-0

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.

Tsaroev B. , Sharifulin R. , Afanasyev A. , Khrushchev S. , Murtazaliev M. , Lovtsova D. , Kashapov R. , Ruzankin P. , Mustaev M. , Bogachev-Prokophiev A.
Concomitant ablation for non-paroxysmal atrial fibrillation: combined energy versus cryoablation alone
Frontiers in Cardiovascular Medicine. 2024. V.11. 1448523 :1-9. DOI: 10.3389/fcvm.2024.1448523 WOS Scopus РИНЦ OpenAlex

Submitted:	Jun 13, 2024
Accepted:	Sep 3, 2024
Published print:	Sep 18, 2024
Published online:	Sep 18, 2024

Web of science:	WOS:001330772600001
Scopus:	2-s2.0-85205358239
Elibrary:	74428108
OpenAlex:	W4402616843

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