Evidence map›Paper›PMID 36908163›Full record

ArticleCardiology journal2024

Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice?

Carlos Antonio Álvarez-Ortega, César Rainer Solórzano Guillén, Alberto Barrera Cordero, Jorge Enrique Toquero Ramos, Jesús Daniel Martínez-Alday, Carlos Eugenio Grande Morales, Aníbal Rodríguez González, Arcadio García Alberola, Luisa Pérez Álvarez, Ángel Ferrero de Loma Osorio and 5 more

Registry-linked trialAbstract readMulticenter Study
In one paragraph

Article in Cardiology journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02785991 (Prospective Observational Study of Pulmonary Vein Cryoablation in Subjects With Atrial Fibrillation), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02785991 completednot on this map

Prospective Observational Study of Pulmonary Vein Cryoablation in Subjects With Atrial Fibrillation (AF) in Spain

TypeobservationalSponsorMedtronic Cardiac Ablation SolutionsRan2016 to 2021Enrolled1,742ConditionsAtrial FibrillationArmsBalloon cryoablation
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Carlos Antonio Álvarez-OrtegaArrhythmia Unit, Cardiology Department, University Hospital La Paz, Madrid, Spain. calvarezo@gmail.com.ORCID 0000-0002-1220-0451
César Rainer Solórzano GuillénArrhythmia Unit, Cardiology Department, University Hospital La Paz, Madrid, Spain.ORCID 0000-0003-4739-5364
Alberto Barrera CorderoHospital Universitario Vírgen de la Victoria, Málaga, Spain.ORCID 0000-0002-0449-9916
Jorge Enrique Toquero RamosHospital Universitario Puerta de Hierro, Majadahonda, Spain.ORCID 0000-0002-9549-9064
Jesús Daniel Martínez-AldayBasurto University Hospital, Bilbao, Spain.ORCID 0000-0002-5424-6060
Carlos Eugenio Grande MoralesHospital Universitario Son Espases, Palma, Spain.ORCID 0000-0003-1580-2172
Aníbal Rodríguez GonzálezHospital Universitario De Canarias, Tenerife, Spain.
Arcadio García AlberolaHospital Universitario Vírgen de la Arrixaca, Murcia, Spain.ORCID 0000-0003-1928-865X
Luisa Pérez ÁlvarezComplejo Hospitalario Universitario de Coruña, Spain.ORCID 0000-0002-9623-6733
Ángel Ferrero de Loma OsorioHospital Universitario Clínico de Valencia, Spain.ORCID 0000-0001-9167-2678
Julio Salvador Hernández AfonsoHospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain.ORCID 0000-0002-0982-1759
Rocío Cózar LeónHospital Universitario Vírgen Macarena, Sevilla, Spain.ORCID 0000-0002-5184-4014
Óscar Cano PérezHospital Universitario La Fé, Valencia, Spain.ORCID 0000-0001-6783-0138
Emilce TruccoHospital Universitario Josep Trueta, Girona, Spain.ORCID 0000-0001-5769-7038
Rafael Peinado PeinadoArrhythmia Unit, Cardiology Department, University Hospital La Paz, Madrid, Spain.ORCID 0000-0002-3686-0892

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAblation of atrial fibrillation (AF), both cryoablation ablation (CBA) and radiofrequency catheter ablation (RFCA), have demonstrated to be safe and effective. About 1 in 3 patients may face a redo due to recurrence and the best technique is unknown. The aim of this study is to assess the efficacy of CBA as a repeat procedure in patients with prior CBA or RFCA.

methodsA nation-wide CBA registry (RECABA) was analyzed and patients were compared who had previously undergone CBA (Prior-CB) or RFCA (Prior-RF). The primary endpoint was AF recurrence at 12 months after a 3-month blanking period. A survival analysis was performed, univariate and multivariate Cox models were also built.

resultsSeventy-four patients were included. Thirty-three (44.6%) were in the Prior-CB group and 41 (55.4%) in the Prior-RF. There were more reconnected pulmonary veins in the Prior-RF than in Prior-CB group (40.4% vs.16.5%, p = 0.0001). The 12-month Kaplan-Meier estimate of freedom from AF recurrence after the blanking period was 61.0% (95% confidence interval [CI] 41.4-75.8%) in the Prior-CB, and 89.2% (95% CI 73.6-95.9%) in the Prior-RF group (p = 0.002). Multivariate Cox regression pointed Prior-CB as the sole independent predictor of AF recurrence, with an adjusted HR of 2.67 (95% CI 1.05-6.79).

conclusionsRepeat CBA shows higher rates of AF recurrences compared to CBA after a previous RFCA despite presenting less reconnected veins at the procedure. These data suggest that patients with AF recurrence after CBA may benefit from other ablation techniques after a recurrence. RECABA is registered at clinicaltrials.gov with the Unique Identifier NCT02785991.

Indexed as

Atrial FibrillationCryosurgeryRecurrenceRegistriesReoperationAgedCatheter AblationFemaleFollow-Up StudiesHumansMaleMiddle AgedPulmonary VeinsRetrospective StudiesRisk FactorsTime Factorsatrial fibrillationcatheter ablationcryoablationradiofrequency catheter ablation

Identifiers

PMID36908163
PMCPMC11076032

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.