Quality of life outcomes in cryoablation of atrial fibrillation–A literature review

Published on Aug 25, 2021in Pacing and Clinical Electrophysiology1.303
· DOI :10.1111/PACE.14341
Bert Vandenberk11
Estimated H-index: 11
(Katholieke Universiteit Leuven),
Laurens Lauwers (Katholieke Universiteit Leuven)+ 4 AuthorsPeter Haemers6
Estimated H-index: 6
(Katholieke Universiteit Leuven)
Sources
Abstract
Background null Cryoballoon ablation (CRYO) for pulmonary vein isolation (PVI) in atrial fibrillation (AF) has become an established treatment option as alternative for radiofrequency catheter ablation (RFCA). As symptom relief is still the main indication for PVI, quality of life (QoL) is a key outcome parameter. This review summarizes the evidence about the evolution of QoL after CRYO. null Methods null A search for clinical studies reporting QoL outcomes after CRYO was performed on PUBMED and COCHRANE. A total of 506 publications were screened and 10 studies met the in- and exclusion criteria. null Results null All studies considered QoL as a secondary endpoint and reported significant improvement in QoL between baseline and 12 months follow-up, independent of the QoL instruments used. The effect size of CRYO on QoL was comparable between studies and present in both paroxysmal and persistent AF. Direct comparison between CRYO and RFCA was limited to two studies, there was no difference between ablation modalities after 12 months FU. Two studies in paroxysmal AF reported outcome beyond 12 months follow-up and QoL improvement was maintained up to 36 months after ablation. There were no long-term data available for persistent AF. null Conclusion null CRYO of AF significantly improves QoL. The scarce amount of data with direct comparison between subgroups limits further exploration. Assessment of QoL should be considered a primary outcome parameter in future trials with long-term follow-up.
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#2Nikola Pavlović (University Hospital Centre Zagreb)H-Index: 13
Last. Cryo-FIRST InvestigatorsH-Index: 1
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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 randomiz...
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#2George A. Wells (UBC: University of British Columbia)H-Index: 155
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Abstract Background Guidelines recommend a trial of one or more antiarrhythmic drugs before catheter ablation is considered in patients with atrial fibrillation. However, first-line ablation may be...
66 CitationsSource
#1Oussama M Wazni (Grandview Medical Center)H-Index: 1
#2Gopi Dandamudi (Grandview Medical Center)H-Index: 24
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Abstract Background In patients with symptomatic paroxysmal atrial fibrillation that has not responded to medication, catheter ablation is more effective than antiarrhythmic drug therapy for mainta...
61 CitationsSource
#1Maria Terricabras (U of T: University of Toronto)H-Index: 3
#2Roberto MantovanH-Index: 16
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Importance Catheter ablation is effective in reducing atrial fibrillation (AF), but the association of ablation for AF with quality of life is unclear. Objective To evaluate whether the procedural outcome of ablation for AF is associated with quality of life (QOL) measures. Design, Setting, and Participants This was a prespecified secondary analysis of the Substrate and Trigger Ablation for Reduction of Atrial Fibrillation-Part II (STAR AF II) prospective randomized clinical trial, which compare...
4 CitationsSource
#1Wilber SuH-Index: 10
#2Vivek Y. Reddy (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 92
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Abstract Background Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation to treat patients with symptomatic drug-refractory atrial fibrillation (AF). Objectives To assess the safety and efficacy of PVI using the cryoballoon catheter to treat patients with persistent AF. Methods STOP Persistent AF (NCT03012841) was a prospective, multicenter, single-arm, FDA-regulated trial designed to evaluate the safety and efficacy of PVI-only cryoballoon ablation for drug-refractory persiste...
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#1Jason G. Andrade (UBC: University of British Columbia)H-Index: 30
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Abstract Objectives This study evaluated the impact of contact force–guided radiofrequency ablation versus cryoballoon ablation on quality of life and health care utilization. Background Traditional outcome parameters, such as arrhythmia-free survival, are insufficient to evaluate the clinical impact of atrial fibrillation (AF), as it fails to the capture patient- and health system–level differences in treatment approaches. Methods The CIRCA-DOSE (Cryoballoon Vs. Contact-Force Atrial Fibrillatio...
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#1Mattias Duytschaever (UGent: Ghent University)H-Index: 23
#2Jan De Pooter (UGent: Ghent University)H-Index: 2
Last. Rene TavernierH-Index: 28
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Abstract Background Few studies evaluated the impact of catheter ablation (CA) on atrial tachyarrhythmia (ATA) burden in paroxysmal atrial fibrillation (AF). Objective In the prospective, patient-controlled CLOSE to CURE study we studied longer-term impact of optimized CA on ATA burden using insertable cardiac monitors (ICM). Methods 105 PAF patients were implanted with an ICM 65 [61-78] days before CA. CA consisted of contact force guided pulmonary vein isolation (PVI) targeting an intertag dis...
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#1Sandeep Jain (University of Pittsburgh)H-Index: 19
#2Paul Novak (UBC: University of British Columbia)H-Index: 21
Last. Bradley P. Knight (NU: Northwestern University)H-Index: 68
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Abstract Background Pulmonary vein isolation by catheter ablation is a Class IA indication for the treatment of symptomatic, drug-refractory, paroxysmal atrial fibrillation (PAF). Quality of life (QoL) has been identified as a clinically meaningful endpoint but has not been comprehensively evaluated to date. Objective Evaluate the effects of cryoballooon ablation on long-term QoL. Methods As part of the STOP-AF Post-Approval Study, QoL was assessed using the Short Form-12 Health Survey (SF-12) a...
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#1Jason G. Andrade (UBC: University of British Columbia)H-Index: 30
#2Jean Champagne (Laval University)H-Index: 20
Last. Paul Khairy (MHI: Montreal Heart Institute)H-Index: 70
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Background: Advanced generation ablation technologies have been developed to achieve more effective pulmonary vein isolation (PVI) and minimize arrhythmia recurrence following atrial fibrillation (...
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