Cryoballoon ablation versus remote magnetic navigation ablation in patients with paroxysmal atrial fibrillation: a prospective controlled study

Objective Cryoballoon-based ablation(CBA)and remote magnetic navigation-guided(RMN)ablation are two novel means to treat paroxysmal atrial fibrillation(PAF), however, no controlled data have been reported in China.This prospective, controlled study was to assess the safety and efficacy of these two techniques and compare the procedure-related outcome. Methods A total of 60 patients with PAF were enrolled and divided into two groups(CBA group, n=30; RMN group, n=30). The primary endpoint was acute success of complete pulmonary vein isolation(PVI). The secondary endpoints were procedural parameters including complications, procedure time, ablation time, and fluoroscopy time.Freedom from atrial fibrillation(AF)recurrence was evaluated at 3 months follow-up. Results Complete PVI were achieved during the first ablation procedure in CBA group.Acute success rate of PVI was 97% of patients in RMN group.No major complication including cardiac temponade and atrial-esophageal fistulae occurred in RMN group.Phrenic nerve palsy occurred in one patient of CBA group.The complication rate was not different.Compared to RMN group, procedure time of CBA group was significantly reduced [(142±36) min vs.(108±30) min, P<0.01]; However, fluoroscopy time was increased by 10 min[(6.5±2.8) min vs.(16.4±4.8) min, P<0.001]. AF recurrence was similar between these two groups(RMN vs. CBA: 16.7% vs. 23.0%, P=0.75)within 3 months(blanking period). Conclusion Both CBA and RMN are safe and effective to complete PVI in patients with PAF.Our data indicated that RMN-guided PAf ablation can markedly reduce the fluoroscopy time, and CBA can shorten the procedure time. Key words: Atrial fibrillation; Pulmonary vein isolation; Cryoballoon ablation; Remote magnetic navigation