Comparative analysis of three-year efficacy of catheter ablation of atrial fibrillation using the Ablation Index module and the second-generation cryoballoon

Aim. To compare immediate and long-term outcomes of catheter-based atrial fibrillation (AF) treatment following pulmonary vein (PV) cryoballoon ablation (CBA) using the second-generation cryoballoon and PV radiofrequency ablation (RFA) performed on the navigation system using the contact force-sensing catheter with the AI module.
Methods. The study included 199 patients referred for PV isolation between 2018 and 2021. Patients were divided into two groups: the study group (n=110) underwent PV isolation via RFA using the catheter with the AI module; the control group (n=89) underwent PV CBA using the second-generation cryoballoon. The follow-up period was limited to 36 months, with a mean follow-up of 27.9 ± 14.2 months.
Results. The three-year efficacy of CBA and RFA using the AI module was comparable (freedom from atrial tachy­ arrhythmias: RFA group 0.61±0.05, CBA group 0.62±0.05 (Log-Rank test, p = 0.896)), with similar complication rates and profiles (3.6% (n=4) vs. 4.5% (n=4), p=0.759). The AF recurrence rate during the blanking period was significantly lower in the RFA group using the AI module (1.8% (n=2) vs. 9.0% (n=8) in the CBA group, p=0.045). Procedure duration was significantly shorter in the cryoablation group (RFA 92.7±20.9 min, CBA 83.9±19.6 min, p=0.005). The need for repeat intervention was comparable between groups (RFA 21.8% (n=24), CBA 30.3% (n=27), p=0.171).
Conclusion. Comparative analysis of the three-year efficacy of radiofrequency antral pulmonary vein isolation using the catheter with the “Ablation Index” (AI) module demonstrated results comparable to ablation with the secondgeneration cryoballoon. Furthermore, during the blanking period, the RFA group showed a statistically significant reduction in AF recurrence compared to the CBA group.

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