Cryoballoon for pulmonary vein isolation: Is it better tolerated than radiofrequency? Retrospective study comparing the use of analgesia and sedation in both ablation techniques.

摘要

BACKGROUND: Treatment of atrial fibrillation (AF) by radiofrequency or cryoballoon ablation requires good sedation and effective analgesia to be carried out safely and successfully. AIM: To compare analgesic and sedative drug usage during ablation procedures for paroxysmal AF. METHODS: The records of 60 patients hospitalized for ablation of paroxysmal AF were studied. Patients were divided into two groups, according to the technique used: radiofrequency ablation (group A) and cryoballoon ablation (group B). Anaesthetic and sedative medication usage was compared between groups. RESULTS: Patients' mean age was 56.2 +/- 1 years in the radiofrequency group and 57.0 +/- 0.74 years in the cryoballoon group; mean duration of AF was 6.91+/-2.36 and 6.77 +/- 2.51 years, respectively. Twenty patients from group A and 18 from group B had transesophageal echocardiography. With regard to sedative use, 3.01 +/- 1.3 mg/m(2) of midazolam was used in group A versus 3.5 +/- 1.26 mg/m(2) in group B (p=0.14). Propofol was seldom used. For analgesia, 0.31 +/- 0.26 g/m(2) of paracetamol was used in group A versus 0.73 +/- 1.86 g/m(2) in group B (p=0.23). Mean morphine dose was higher in group A versus group B (3 +/- 1.5 vs 2.09 +/- 1.02 mg/m(2), respectively; p=0.01). CONCLUSION: In this study, patients who underwent cryoballoon ablation required a lower dose of morphine compared with those who underwent radiofrequency ablation. Catheter cryoballoon ablation appears better tolerated than radiofrequency ablation for the treatment of paroxysmal AF.