Cryoballoon for pulmonary vein isolation: Is it better tolerated than radiofrequency? Retrospective study comparing the use of analgesia and sedation in both ablation techniques.
BACKGROUND
Treatment of atrial fibrillation (AF) by radiofrequency or cryoballoon ablation requires good sedation and effective analgesia to be carried out safely and successfully.


OBJECTIVE
To compare analgesic and sedative drug usage during ablation procedures for paroxysmal AF.


METHODS
The records of 60 patients hospitalized for ablation of paroxysmal AF were studied. Patients were divided into two groups, according to the technique used: radiofrequency ablation (group A) and cryoballoon ablation (group B). Anaesthetic and sedative medication usage was compared between groups.


RESULTS
Patients' mean age was 56.2 +/- 1 years in the radiofrequency group and 57.0 +/- 0.74 years in the cryoballoon group; mean duration of AF was 6.91+/-2.36 and 6.77 +/- 2.51 years, respectively. Twenty patients from group A and 18 from group B had transesophageal echocardiography. With regard to sedative use, 3.01 +/- 1.3 mg/m(2) of midazolam was used in group A versus 3.5 +/- 1.26 mg/m(2) in group B (p=0.14). Propofol was seldom used. For analgesia, 0.31 +/- 0.26 g/m(2) of paracetamol was used in group A versus 0.73 +/- 1.86 g/m(2) in group B (p=0.23). Mean morphine dose was higher in group A versus group B (3 +/- 1.5 vs 2.09 +/- 1.02 mg/m(2), respectively; p=0.01).


CONCLUSIONS
In this study, patients who underwent cryoballoon ablation required a lower dose of morphine compared with those who underwent radiofrequency ablation. Catheter cryoballoon ablation appears better tolerated than radiofrequency ablation for the treatment of paroxysmal AF.
Defaye
Pascal
P
Department of Cardiology, University Hospital, 38043 Grenoble, France. PDefaye@chu-grenoble.fr
Kane
Adama
A
Jacon
Peggy
P
Mondesert
Blandine
B
D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D016009:Chi-Square Distribution; D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation; D017723:Drug Utilization Review; D017548:Echocardiography, Transesophageal; D004867:Equipment Design; D005260:Female; D005602:France; D006760:Hospitalization; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D015742:Propofol / Q000627:therapeutic use; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000700:Analgesics; D006993:Hypnotics and Sedatives; D000082:Acetaminophen; D009020:Morphine; D008874:Midazolam; D015742:Propofol