Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 19;13(6):e033146.
doi: 10.1161/JAHA.123.033146. Epub 2024 Mar 12.

Pentaspline Pulsed Field Ablation Catheter Versus Cryoballoon for Atrial Fibrillation Ablation: Results From a Prospective Comparative Study

Corentin Chaumont  1   2 , Camilia Hayoun  1 , Arnaud Savoure  1 , Raphael Al Hamoud  1 , Nathanael Auquier  1 , Emily McDonnell  1 , Helene Eltchaninoff  1   2 , Frederic Anselme  1   2
Affiliations

Pentaspline Pulsed Field Ablation Catheter Versus Cryoballoon for Atrial Fibrillation Ablation: Results From a Prospective Comparative Study

Corentin Chaumont et al. J Am Heart Assoc. .

Abstract

Background: Cryoballoon ablation is currently the gold standard technique for single-shot pulmonary vein isolation (PVI). Pulsed field ablation (PFA) has recently emerged as an interesting nonthermal alternative energy for PVI. The purpose of our study was to evaluate the safety and long-term efficacy of PVI using the pentaspline PFA catheter in comparison to cryoballoon ablation.

Methods and results: Between January 2021 and December 2022, we included all consecutive patients of our center in whom a first PVI-only procedure was performed using PFA or cryoballoon. The choice of the energy was based on patients' preference between general anesthesia (PFA) and local anesthesia (cryoballoon). The primary end point was freedom from documented atrial arrhythmia recurrence after a 3-month blanking period. A total of 301 patients (paroxysmal atrial fibrillation in 220 patients) underwent a first PVI procedure performed using PFA (n=151) or cryoballoon (n=150). Complete short-term PVI was obtained in 144 of 150 patients (96%) in the cryoballoon group and in all patients of the PFA group (P=0.01). Procedure duration was significantly longer in the cryoballoon group. Transient and persistent phrenic nerve injuries were observed in the cryoballoon group only (13/150 and 2/150, respectively). One-year freedom from atrial arrhythmia was significantly higher in the PFA group compared with the cryoballoon group (87.9% versus 77.7%; adjusted hazard ratio, 0.53 [95% CI, 0.30-0.96]; P=0.037).

Conclusions: This prospective, comparative, real-life study suggested that PFA could overcome safety limitations of cryoballoon with optimal effectiveness. Randomized controlled studies are required to further investigate the potential superiority of PFA over cryoballoon.

Keywords: atrial fibrillation; catheter ablation; cryoballoon ablation; pulmonary vein isolation; pulsed field ablation.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Freedom from atrial arrhythmia recurrence in the overall population, according to the ablation technique (cryoballoon [CB] vs pulsed field ablation [PFA]).
aHR indicates adjusted HR; HR, hazard ratio; and KM, Kaplan‐Meier.
Figure 2
Figure 2. Freedom from atrial arrhythmia recurrence in patients with paroxysmal atrial fibrillation (AF) (2A) or persistent AF (2B), according to the ablation technique (cryoballoon [CB] vs pulsed field ablation [PFA]).
aHR indicates adjusted HR; HR, hazard ratio; and KM, Kaplan‐Meier.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström‐Lundqvist C, Boriani G, Castella M, Dan GA, Dilaveris PE, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio‐Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European heart rhythm association (EHRA) of the ESC. Eur Heart J. 2021;42:373–498. doi: 10.1093/eurheartj/ehaa612 - DOI - PubMed
    1. Kuck KH, Brugada J, Fürnkranz A, Metzner A, Ouyang F, Chun KR, Elvan A, Arentz T, Bestehorn K, Pocock SJ, et al. Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation. N Engl J Med. 2016;374:2235–2245. doi: 10.1056/NEJMoa1602014 - DOI - PubMed
    1. Luik A, Radzewitz A, Kieser M, Walter M, Bramlage P, Hörmann P, Schmidt K, Horn N, Brinkmeier‐Theofanopoulou M, Kunzmann K, et al. Cryoballoon versus open irrigated radiofrequency ablation in patients with paroxysmal atrial fibrillation: the prospective, randomized, controlled, noninferiority FreezeAF study. Circulation. 2015;132:1311–1319. doi: 10.1161/CIRCULATIONAHA.115.016871 - DOI - PMC - PubMed
    1. Sánchez‐Quintana D, Cabrera JA, Climent V, Farré J, Weiglein A, Ho SY. How close are the phrenic nerves to cardiac structures? Implications for cardiac interventionalists. J Cardiovasc Electrophysiol. 2005;16:309–313. doi: 10.1046/j.1540-8167.2005.40759.x - DOI - PubMed
    1. Andrade JG, Khairy P, Guerra PG, Deyell MW, Rivard L, Macle L, Thibault B, Talajic M, Roy D, Dubuc M. Efficacy and safety of cryoballoon ablation for atrial fibrillation: a systematic review of published studies. Heart Rhythm. 2011;8:1444–1451. doi: 10.1016/j.hrthm.2011.03.050 - DOI - PubMed