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

Arch Cardiovasc Dis. 2010 Jun-Jul;103(6-7):388-93. doi: 10.1016/j.acvd.2010.06.004. Epub 2010 Aug 12.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Acetaminophen / therapeutic use
  • Adult
  • Aged
  • Analgesics / therapeutic use*
  • Atrial Fibrillation / diagnostic imaging
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Catheter Ablation* / adverse effects
  • Chi-Square Distribution
  • Cryosurgery* / adverse effects
  • Cryosurgery* / instrumentation
  • Drug Utilization Review
  • Echocardiography, Transesophageal
  • Equipment Design
  • Female
  • France
  • Hospitalization
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Male
  • Midazolam / therapeutic use
  • Middle Aged
  • Morphine / therapeutic use
  • Propofol / therapeutic use
  • Pulmonary Veins / diagnostic imaging
  • Pulmonary Veins / physiopathology
  • Pulmonary Veins / surgery*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Analgesics
  • Hypnotics and Sedatives
  • Acetaminophen
  • Morphine
  • Midazolam
  • Propofol