Conclusions Compared with RF ablation , cryoablation present a comparable long-term AF/atrial tachycardial-free survival and procedure-related adverse events .
Meanwhile , cryoablation markedly shorten the procedure time , nonetheless , with negligible impact on the fluoroscopy time
Aims Cryoablation is a promising alternative technique to RF ablation for treating paroxysmal AF with encouraging results .
However , data about the efficacy and safety comparison between cryoablation and RF ablation is still lacking .
Randomized, Controlled Trial of the Safety and Effectiveness of a Contact Force–Sensing Irrigated Catheter for Ablation of Paroxysmal Atrial Fibrillation: Results of the TactiCath Contact Force Ablation Catheter Study for Atrial Fibrillation (TOCCASTAR) Study
Background — Contact force ( CF ) is a major determinant of lesion size and transmurality and has the potential to improve efficacy of atrial fibrillation ablation . This study sought to evaluate the safety and effectiveness of a novel irrigated radiofrequency ablation catheter that measures real-time CF in the treatment of patients with paroxysmal atrial fibrillation . Methods and Results — A total of 300 patients with symptomatic , drug-refractory , paroxysmal atrial fibrillation were enrolled in a prospect i ve , multicenter , r and omized , controlled trial and r and omized to radiofrequency ablation with either a novel CF-sensing catheter or a non-CF catheter ( control ) . The primary effectiveness end point consisted of acute electrical isolation of all pulmonary veins and freedom from recurrent symptomatic atrial arrhythmia off all antiarrhythmic drugs at 12 months . The primary safety end point included device-related serious adverse events . End points were powered to show noninferiority . All pulmonary veins were isolated in both groups . Effectiveness was achieved in 67.8 % and 69.4 % of subjects in the CF and control arms , respectively ( absolute difference , −1.6 % ; lower limit of 1-sided 95 % confidence interval , −10.7 % ; P=0.0073 for noninferiority ) . When the CF arm was stratified into optimal CF ( ≥90 % ablations with ≥10 g ) and nonoptimal CF groups , effectiveness was achieved in 75.9 % versus 58.1 % , respectively ( P=0.018 ) . The primary safety end point occurred in 1.97 % and 1.40 % of CF patients and control subjects , respectively ( absolute difference , 0.57 % ; upper limit of 1-sided 95 % confidence interval , 3.61 % ; P=0.0004 for noninferiority ) . Conclusions — The CF ablation catheter met the primary safety and effectiveness end points . Additionally , optimal CF was associated with improved effectiveness . Clinical Trial Registration — http://www . clinical trials.gov . Unique identifier : NCT01278953
Conclusions Compared with RF ablation , cryoablation present a comparable long-term AF/atrial tachycardial-free survival and procedure-related adverse events .
Meanwhile , cryoablation markedly shorten the procedure time , nonetheless , with negligible impact on the fluoroscopy time
Aims Cryoablation is a promising alternative technique to RF ablation for treating paroxysmal AF with encouraging results .
However , data about the efficacy and safety comparison between cryoablation and RF ablation is still lacking .