Cryoballoon AF ablation safe and efficacious among patients with HFrEF

While atrial fibrillation (AF) ablation has proven beneficial for heart failure (HF) patients, most reports were performed with radiofrequency ablation. They aimed to evaluate the efficacy and safety of cryoballoon atrial fibrillation ablation in patients with Heart Failure with reduced ejection fraction. They comprehensively searched the databases of MEDLINE, EMBASE, and Cochrane database from inception to December 2022. Studies that reported the outcomes of freedom from atrial arrhythmia, complications, NYHA functional class (NYHA FC), and left ventricular ejection fraction (LVEF) after Cryoballoon atrial fibrillation ablation in heart failure patients were included. Data from each study were combined with a random-effects model. Result: A total of 9 studies observational studies with 1414 heart failure patients were included. Five studies had only heart failure with reduced ejection fraction (HFrEF), 1 study with HF with preserved ejection fraction (HFpEF), and others with mixed heart failure types. Freedom from AA in HFrEF at 12 months was 64% (95% CI 56–71%, I2 58%). There was a significant improvement of LVEF in these patients with a standard mean difference of 13% (95% CI 8.6–17.5%, I2 99% P < 0.001. The complication rate in Heart Failure with reduced ejection fraction group was 6% (95% CI 4–10%, I2 0%). The risk of recurrence of atrial arrhythmia was not significantly different between heart failure and no heart failure patients. Cryoballoon atrial fibrillation ablation is effective in HFrEF patients comparable to radiofrequency ablation. The complication rate was low.

Reference:

Nithi Tokavanich, Witina Techasatian, Narut Prasitlumkum, Wisit Cheungpasitporn, Leenhapong Navaravong, Krit Jongarangsin, Ronpichai Chokesuwattanaskul,

The efficacy and safety of cryoballoon atrial fibrillation ablation in patients with heart failure: A systematic review and meta-analysis. Indian Pacing and Electrophysiology Journal,

2024, ISSN 0972-6292. https://doi.org/10.1016/j.ipej.2024.01.001.

(https://www.sciencedirect.com/science/article/pii/S0972629224000019)

Keywords:

Cryoballoon AF, Cryoballoon ablation, patients with HFrEF, Indian Pacing and Electrophysiology Journal, Cryoballoon ablation; Heart failure; Cryoablation; Atrial fibrillation, Nithi Tokavanich, Witina Techasatian, Narut Prasitlumkum, Wisit Cheungpasitporn, Leenhapong Navaravong, Krit Jongarangsin, Ronpichai Chokesuwattanaskul