RT Journal Article
T1 Repeat Ablation for Atrial Fibrillation Recurrence Post Cryoballoon or Radiofrequency Ablation in the FIRE AND ICE Trial
A1 Kuck, Karl-Heinz
A1 Albenque, Jean-Paul
A1 Chun, K. R. Julian
A1 Fuernkranz, Alexander
A1 Busch, Mathias
A1 Elvan, Arif
A1 Schlueter, Michael
A1 Braegelmann, Kendra M.
A1 Kueffer, Fred J.
A1 Hemingway, Lauren
A1 Arentz, Thomas
A1 Tondo, Claudio
A1 Brugada, Josep
A1 Metzner, Andreas
A1 Fink, Thomas
A1 Lemes, Christine
A1 Chen, Shaojie
A1 Schmidt, Boris
A1 Bologna, Fabrizio
A1 Bordignon, Stefano
A1 Mouden, Mohamed
A1 Muller-Eschenborn, Bjorn
A1 Jadidi, Amir
A1 Kuhne, Michael
A1 Sticherling, Christian
A1 Kruger, Anne
A1 Abdiou, Edison
A1 Mont, Lluis
A1 Benito Martin, Eva Maria
A1 Alarcon Sanz, Francisco
A1 Neuzil, Petr
A1 Dujka, Libor
A1 Ruiz-Granell, Ricardo
A1 Barrera, Alberto
A1 Salas, Amalio Ruiz
A1 Boveda, Serge
A1 Kuhlkamp, Volker
A1 Stanciu, Bogdan
A1 Perez-Castellano, Nicasio
A1 Perez Villacastin, Julian
A1 Canadas Godoy, Victoria
A1 FIRE AND ICE Investigators, 
K1 atrial fibrillation
K1 catheter ablation
K1 hospitalization
K1 pulmonary veins
K1 randomized controlled trial
K1 Pulmonary vein isolation
K1 2nd-generation cryoballoon
K1 Initial ablation
K1 Contact-force
AB Background: The FIRE AND ICE trial assessed efficacy and safety of pulmonary vein (PV) isolation using cryoballoon versus radiofrequency current (RFC) ablation in patients with drug refractory, symptomatic, paroxysmal atrial fibrillation (AF). The purpose of the current study was to assess index lesion durability as well as reablation strategy and outcomes in trial patients undergoing a reablation procedure.Methods: Patients with reablation procedures during FIRE AND ICE were retrospectively consented and enrolled at 13 trial centers. The first reablation for each patient was included in the analysis. Documented arrhythmias before reablation, number and location of reconnected PVs, lesions created during reablations, procedural characteristics, and acute as well as long-term outcomes were assessed.Results: Eighty-nine (36 cryoballoon and 53 RFC) patients were included in this study. Paroxysmal atrial fibrillation was the predominant recurrent arrhythmia (69%) before reablation. Reablations occurred at a median of 173 and 182 days (P=0.54) in the cryoballoon and RFC cohorts, respectively. The number of reconnected PVs was significantly higher in the RFC than the cryoballoon group (2.11.4 versus 1.41.1; P=0.010), which was driven by significantly more reconnected left superior PVs and markedly more reconnected right superior PVs. The number of (predominantly RFC) lesions applied during reablation was significantly greater in patients originally treated with RFC (3.3 +/- 1.3 versus 2.5 +/- 1.5; P=0.015) with no difference in overall acute success (P=0.70). After reablation, no differences in procedure-related rehospitalization or antiarrhythmic drug utilization were observed between cohorts.Conclusions: At reablation, patients originally treated with the cryoballoon had significantly fewer reconnected PVs, which may reflect RFC catheter instability in certain left atrial regions, and thus required fewer lesions for reablation success. Repeat ablations were predominantly performed with RFC and resulted in similar acute success, duration of hospitalization, and antiarrhythmic drug prescription between the study cohorts.Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03314753.
PB Lippincott williams & wilkins
SN 1941-3149
YR 2019
FD 2019-06-01
LK https://hdl.handle.net/10668/26897
UL https://hdl.handle.net/10668/26897
LA en
DS RISalud
RD Apr 17, 2025