title: Comparison between radiofrequency with contact force-sensing and second-generation cryoballoon for paroxysmal atrial fibrillation catheter ablation: a multicentre European evaluation.
abstract: OBJECTIVE
  Whether pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) using contact force (CF)-guided radiofrequency (RF) or second-generation cryoballoon (CB) present similar efficacy and safety remains uncertain.
  
  
  RESULTS
  We performed a multicentre study comparing procedural safety and arrhythmia recurrence after standardized PVI catheter ablation for PAF using CF-guided RF ablation (Thermocool(®) SmartTouch™, Biosense Webster; or Tacticath™, St Jude Medical) (CF group) with second-generation CB ablation (Arctic Front Advance™, Medtronic) (CB group). Overall, 376 patients (mean age 59.8 ± 10.4 years, 280 males) were enrolled in 4 centres: 198 in CF group and 178 in CB group. Procedure was shorter for CB group than for CF group (109.6 ± 40 vs. 122.5 ± 40.7 min, P = 0.003), but fluoroscopy duration and X-ray exposure were not statistically different (P = 0.1 and P = 0.22, respectively). Overall complication rate was similar in both groups: 14 (7.1%) in the CF group vs. 13 (7.3%) in the CB group (P = 0.93). However, transient right phrenic nerve palsy occurred only in CB group (10 patients, 5.6%; P = 0.001 vs. CF group) and severe non-lethal complications (embolic event, tamponade, or oesophageal injury) occurred only in CF group (5 patients, 2.5%; P = 0.03 vs. CB group). No periprocedural death occurred in either group. Single-procedure freedom from any atrial arrhythmias at 18 months post-ablation was comparable in CF group and CB group (76 vs. 73.3%, respectively, log rank P = 0.63).
  
  
  CONCLUSIONS
  Pulmonary vein isolation using CF-guided RF and second-generation CB leads to comparable single-procedure arrhythmia-free survival at up to 18 months with similar overall complication rate.
authors.affiliation: Cardiology Department, Pasteur University Hospital, 30 Voie romaine, 06000 Nice, France Clinique Ambroise Paré, Neuilly, France fabiensquara@gmail.com.
authors.forename: Fabien
authors.initials: F
authors.lastname: Squara
authors.affiliation: Clinique Ambroise Paré, Neuilly, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Zhao
authors.affiliation: Clinique Pasteur, Toulouse, France Cardiology Department, European Georges Pompidou Hospital, Paris, France.
authors.forename: Eloi
authors.initials: E
authors.lastname: Marijon
authors.affiliation: Service de Cardiologie, Centre Hospitalier Princesse Grace, Monaco.
authors.forename: Decebal Gabriel
authors.initials: DG
authors.lastname: Latcu
authors.affiliation: Clinique Pasteur, Toulouse, France.
authors.forename: Rui
authors.initials: R
authors.lastname: Providencia
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Di Giovanni
authors.affiliation: Clinique Ambroise Paré, Neuilly, France.
authors.forename: Gaël
authors.initials: G
authors.lastname: Jauvert
authors.affiliation: Clinique Pasteur, Toulouse, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Jourda
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Carlo
authors.initials: C
authors.lastname: De Asmundis
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciconte
authors.affiliation: Clinique Ambroise Paré, Neuilly, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Alonso
authors.affiliation: Clinique Ambroise Paré, Neuilly, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Grimard
authors.affiliation: Clinique Pasteur, Toulouse, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Boveda
authors.affiliation: Clinique Ambroise Paré, Neuilly, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Cauchemez
authors.affiliation: Service de Cardiologie, Centre Hospitalier Princesse Grace, Monaco.
authors.forename: Nadir
authors.initials: N
authors.lastname: Saoudi
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
authors.affiliation: Clinique Pasteur, Toulouse, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Albenque
authors.affiliation: Clinique Ambroise Paré, Neuilly, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Thomas
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D062906:Cardiac Catheters; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation*; D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation*; D018572:Disease-Free Survival; D004867:Equipment Design; D005060:Europe; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014160:Transducers, Pressure; D016896:Treatment Outcome
keywords: Ablation; Atrial fibrillation; Cryoballoon; Radiofrequency