Cryoballoon ablation vs. antiarrhythmic drugs: first-line therapy for patients with paroxysmal atrial fibrillation
Malte Kuniss
1
,
N Pavlovic
2
,
Vedran Velagic
3
,
Jean-Sylvain Hermida
4
,
Stewart Healey
5
,
Giuseppe Arena
6
,
Nicolas Badenco
7
,
Christian Meyer
8
,
Jian Chen
9
,
Saverio Iacopino
10
,
Frédéric Anselme
11
,
Douglas L Packer
12
,
Heinz-Friedrich Pitschner
1
,
Carlo De Asmundis
13
,
Stephan Willems
14
,
Fabio Di Piazza
15
,
Daniel Becker
16
,
Gian-Battista Chierchia
13
2
Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
|
3
University Hospital Centre Zagreb, ZAGREB, Croatia
|
4
Centre Hospitalier Universitaire d'Amiens-Picardie, Amiens, France
|
6
Ospedale Apuane, Massa Carrara, Italy
|
8
University Heart Center, Hamburg, Cardiac Neuro- and Electrophysiology Research Consortium, EVK Düsseldorf, Düsseldorf, Germany
|
9
15
Medtronic, Core Clinical Solutions, Study and Scientific Solutions, Rome, Italy
|
16
Medtronic, Meerbusch, Germany
|
Publication type: Journal Article
Publication date: 2021-03-17
scimago Q1
wos Q1
SJR: 3.057
CiteScore: 12.6
Impact factor: 7.4
ISSN: 10995129, 15322092
PubMed ID:
33728429
Cardiology and Cardiovascular Medicine
Physiology (medical)
Abstract
Aims
Treatment guidelines for patients with atrial fibrillation (AF) suggest that patients should be managed with an antiarrhythmic drug (AAD) before undergoing catheter ablation (CA). This study evaluated whether pulmonary vein isolation employing cryoballoon CA is superior to AAD therapy for the prevention of atrial arrhythmia (AA) recurrence in rhythm control naive patients with paroxysmal AF (PAF).
Methods and results
A total of 218 treatment naive patients with symptomatic PAF were randomized (1 : 1) to cryoballoon CA (Arctic Front Advance, Medtronic) or AAD (Class I or III) and followed for 12 months. The primary endpoint was ≥1 episode of recurrent AA (AF, atrial flutter, or atrial tachycardia) >30 s after a prespecified 90-day blanking period. Secondary endpoints included the rate of serious adverse events (SAEs) and recurrence of symptomatic palpitations (evaluated via patient diaries). Freedom from AA was achieved in 82.2% of subjects in the cryoballoon arm and 67.6% of subjects in the AAD arm (HR = 0.48, P = 0.01). There were no group differences in the time-to-first (HR = 0.76, P = 0.28) or overall incidence [incidence rate ratio (IRR)=0.79, P = 0.28] of SAEs. The incidence rate of symptomatic palpitations was lower in the cryoballoon (7.61 days/year) compared with the AAD arm (18.96 days/year; IRR = 0.40, P < 0.001).
Conclusions
Cryoballoon CA was superior to AAD therapy, significantly reducing AA recurrence in treatment naive patients with PAF. Additionally, cryoballoon CA was associated with lower symptom recurrence and a similar rate of SAEs compared with AAD therapy.
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182
Total citations:
182
Citations from 2024:
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(50.55%)
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Kuniss M. et al. Cryoballoon ablation vs. antiarrhythmic drugs: first-line therapy for patients with paroxysmal atrial fibrillation // Europace. 2021. Vol. 23. No. 7. pp. 1033-1041.
GOST all authors (up to 50)
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Kuniss M., Pavlovic N., Velagic V., Hermida J., Healey S., Arena G., Badenco N., Meyer C., Chen J., Iacopino S., Anselme F., Packer D. L., Pitschner H., Asmundis C. D., Willems S., Di Piazza F., Becker D., Chierchia G. Cryoballoon ablation vs. antiarrhythmic drugs: first-line therapy for patients with paroxysmal atrial fibrillation // Europace. 2021. Vol. 23. No. 7. pp. 1033-1041.
Cite this
RIS
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TY - JOUR
DO - 10.1093/europace/euab029
UR - https://doi.org/10.1093/europace/euab029
TI - Cryoballoon ablation vs. antiarrhythmic drugs: first-line therapy for patients with paroxysmal atrial fibrillation
T2 - Europace
AU - Kuniss, Malte
AU - Pavlovic, N
AU - Velagic, Vedran
AU - Hermida, Jean-Sylvain
AU - Healey, Stewart
AU - Arena, Giuseppe
AU - Badenco, Nicolas
AU - Meyer, Christian
AU - Chen, Jian
AU - Iacopino, Saverio
AU - Anselme, Frédéric
AU - Packer, Douglas L
AU - Pitschner, Heinz-Friedrich
AU - Asmundis, Carlo De
AU - Willems, Stephan
AU - Di Piazza, Fabio
AU - Becker, Daniel
AU - Chierchia, Gian-Battista
PY - 2021
DA - 2021/03/17
PB - Oxford University Press
SP - 1033-1041
IS - 7
VL - 23
PMID - 33728429
SN - 1099-5129
SN - 1532-2092
ER -
Cite this
BibTex (up to 50 authors)
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@article{2021_Kuniss,
author = {Malte Kuniss and N Pavlovic and Vedran Velagic and Jean-Sylvain Hermida and Stewart Healey and Giuseppe Arena and Nicolas Badenco and Christian Meyer and Jian Chen and Saverio Iacopino and Frédéric Anselme and Douglas L Packer and Heinz-Friedrich Pitschner and Carlo De Asmundis and Stephan Willems and Fabio Di Piazza and Daniel Becker and Gian-Battista Chierchia},
title = {Cryoballoon ablation vs. antiarrhythmic drugs: first-line therapy for patients with paroxysmal atrial fibrillation},
journal = {Europace},
year = {2021},
volume = {23},
publisher = {Oxford University Press},
month = {mar},
url = {https://doi.org/10.1093/europace/euab029},
number = {7},
pages = {1033--1041},
doi = {10.1093/europace/euab029}
}
Cite this
MLA
Copy
Kuniss, Malte, et al. “Cryoballoon ablation vs. antiarrhythmic drugs: first-line therapy for patients with paroxysmal atrial fibrillation.” Europace, vol. 23, no. 7, Mar. 2021, pp. 1033-1041. https://doi.org/10.1093/europace/euab029.