Impact of first-line cryoablation for atrial fibrillation on healthcare utilization, arrhythmia disease burden and efficacy outcomes: real-world evidence from the Cryo Global Registry

Zucchelli G 1 , Chun KRJ 2 , Khelae SK 3 , Földesi C 4 , Kueffer FJ 5 , van Bragt KA 5 Show all authors , Scazzuso F 6 , On YK 7 , Al-Kandari F 8 , Okumura K 9 , Cryo Global Registry Investigators

Affiliations 

  • 1 Second Division of Cardiology, Azienda Ospedaliero Universitaria Pisana, Via Roma, 67, 56126, Pisa, Italy. g.zucchelli@ao-pisa.toscana.it
  • 2 Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
  • 3 Institut Jantung Negara, National Heart Institute, Kuala Lumpur, Malaysia
  • 4 Gottsegen György Országos Kardiovaszkuláris Intézet, Budapest, Hungary
  • 5 Medtronic, Inc, Minneapolis, MN, USA
  • 6 Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
  • 7 Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  • 8 Chest Disease Hospital, Kuwait City, Kuwait
  • 9 Saiseikai Kumamoto Hospital, Kumamoto, Japan
J Interv Card Electrophysiol, 2023 Apr;66(3):711-722.
PMID: 36331681 DOI: 10.1007/s10840-022-01388-6

Abstract

BACKGROUND: Cryoballoon ablation (CBA) is an effective first-line treatment for symptomatic atrial fibrillation (AF), as recently demonstrated by three randomized trials. This sub-analysis of the Cryo Global Registry aims to examine current clinical practices of first-line CBA.

METHODS: AF patients treated with first-line CBA were compared to CBA in antiarrhythmic drug (AAD)-refractory patients at 12 months. Efficacy was examined using time-to-first atrial arrhythmia recurrence following a 90-day blanking period. Healthcare utilization was evaluated by repeat ablations and hospitalizations. Disease burden was examined by assessing quality of life (QOL) and patients' reporting of symptoms.

RESULTS: Of 1394 patients, 433 (31.1%) were treated with first-line CBA, which was more frequent in high-volume centers. Serious procedure-related adverse event rates were similar. Efficacy at 12 months was higher in the first-line group (87.8 vs. 81.6%, HRunadj 0.64 (95% CI 0.47-0.88); p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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