Initial rhythm control with cryoballoon ablation vs drug therapy: Impact on quality of life and symptoms

Cryoballoon ablation (CBA) as a first-line rhythm control strategy is superior to antiarrhythmic drugs (AADs) for preventing atrial fibrillation (AF) recurrence; the impact of first-line CBA on quality of life (QoL) and symptoms has not been well characterized. Patients aged 18 to 75 with symptomati...

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Bibliographic Details
Published in:The American heart journal 2021-12, Vol.242, p.103-114
Main Authors: Pavlovic, Nikola, Chierchia, Gian-Battista, Velagic, Vedran, Hermida, Jean Sylvain, Healey, Stewart, Arena, Giuseppe, Badenco, Nicolas, Meyer, Christian, Chen, Jian, Iacopino, Saverio, Anselme, Frédéric, Dekker, Lukas, Scazzuso, Fernando, Packer, Douglas L, de Asmundis, Carlo, Pitschner, Heinz-Friedrich, Piazza, Fabio Di, Kaplon, Rachelle E, Kuniss, Malte
Format: Article
Language:English
Subjects:
Ablation
Adolescent
Adult
Aged
Anti-Arrhythmia Agents - therapeutic use
Arrhythmia
Atrial Fibrillation - drug therapy
Atrial Fibrillation - surgery
Blanking
Cardiac arrhythmia
Catheter Ablation
Catheters
Chemotherapy
Cryosurgery
Drug therapy
Fibrillation
Human health and pathology
Humans
Life Sciences
Mental health
Middle Aged
Patients
Polar environments
Quality of Life
Questionnaires
Rhythm
Treatment Outcome
Young Adult
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Summary:Cryoballoon ablation (CBA) as a first-line rhythm control strategy is superior to antiarrhythmic drugs (AADs) for preventing atrial fibrillation (AF) recurrence; the impact of first-line CBA on quality of life (QoL) and symptoms has not been well characterized. Patients aged 18 to 75 with symptomatic paroxysmal AF naïve to rhythm control therapy were randomized (1:1) to CBA (Arctic Front Advance, Medtronic) or AAD (Class I or III). Symptoms and QoL were assessed at baseline, 1, 3, 6, 9, and 12 months using the EHRA classification and Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) and SF-36v2 questionnaires. Symptomatic palpitations were evaluated via patient diary. Overall, 107 patients were randomized to CBA and 111 to AAD; crossovers occurred in 9%. Larger improvements in the AFEQT summary, subscale and treatment satisfaction scores were observed at 12 months with CBA vs AAD (all P
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2021.08.007