Comparative Study On The Efficacy And Recurrence Factors Of Cryoballoon Ablation And Radiofrequency Catheter Ablation In Patients With Paroxysmal Atrial Fibrillation

BACKGROUND In recent years,cryoballoablation(CBA)has become an effective complement to pulmonary vein isolation in patients with atrial fibrillation(AF),but recurrence is still a more common complication.Since CBA is different from radiofrequency ablation(RFA)in terms of the principles and equipment of ablation,it remains to be seen whether the efficacy of these two ablations in patients with paroxysmal AF and the factors associated with postoperative recurrence are similar.The purpose of this study was to retrospectively investigate whether CBA differs from Ablation index(AI)guided RFA in terms of efficacy,safety,and risk factors associated with postoperative recurrence.METHODS Patients with paroxysmal atrial fibrillation(AF)who underwent catheter ablation at Maanshan People’s Hospital between May 2020 and December 2022 were divided into CBA and AI-guided RFA groups based on ablation modalities.The clinical and follow-up data of the two groups were analyzed to compare and assess the efficacy of the two ablation modalities and the predictive value of atrial tachyarrhythmias(AT)for recurrence in the early postoperative period(within 1 month).In addition,the recurrence factors of CBA were retrospectively analyzed according to the recurrence and non-recurrence of CBA.RESULTS(1)The mean follow-up time after surgery was(14.2±3.0)months,with no significant difference between the CBA and RFA groups of patients with recurrence(P>0.05).(2)17 cases(37.8%)in the CBA group developed early atrial arrhythmias,9of which recurred after surgery;19 cases(47.5%)in the RFA group developed early atrial arrhythmias,5 of which recurred.The CBA group had higher sensitivity,specificity and accuracy in predicting postoperative recurrence of early atrial arrhythmias compared with the RFA group(69.2% vs.50.0%,75.0% vs.53.3%,73.3%vs.52.5%).(3)Age,atrial tachyarrhythmias within 1 month postoperatively,and 6h postoperative c Tn I were statistically different between patients in the recurrent and non-recurrent groups after CBA(P<0.05),and regression analysis suggested a correlation between 6 h postoperative c Tn I and postoperative recurrence(OR=0.61,P<0.05).CONCLUSION For patients with paroxysmal atrial fibrillation,both cryoballoon ablation and AI-guided radiofrequency catheter ablation are safe and effective,with a high first-time ablation success rate and fewer complications;CTn I level monitoring after cryoballoon ablation is helpful for rapid prediction of recurrence of atrial fibrillation and provide clinical basis for secondary ablation.Compared with AI-guided radiofrequency catheter ablation,atrial tachyarrhythmia within 1 month after cryoballoon ablation has higher sensitivity,specificity and accuracy in predicting AF recurrence,but there is no correlation with AF recurrence.The time cutoff of CBA "blank period" may be at least 1 month after ablation.