A Comparison between Cryoablation and Radiofrequency Ablation for Treating Concomitant Atrial Fibrillation during Cardiac Surgery

Background:
Cryoablation (CRYO) and Radiofrequency ablation (RF) are well established procedures used for treating concomitant atrial fibrillation or flutter while undergoing other cardiac surgeries. We sought to compare the efficiency of these two methods in restoring sinus rhythm postoperatively.

Methods:
A retrospective analysis comparing 61 patients with paroxysmal, persistent or long standing persistentatrial fibrillation or atrial flutter who underwent CRYO (n=30) or RF (n=31) ablation during surgery between October 2013 and August 2016 in our center. The primary end point was restoration of sinus rhythm versus non sinus rhythm during the immediate post-operative phase, at one, three and twelve months postoperatively.

Results:
Immediate postoperatively, 27 (90%) of the CRYO group patients were in sinus rhythm versus 22 (71%) of the RF group (p=0.06). Sinus rhythm was restored in 71.4%, 76% and 71.4% of the CRYO group and in 63.3%, 66.7% and 67.9% of the RF group at one, three and twelve months post operative, respectively (p=0.26, 0.14 and 0.23). The 1 year survival rate for the CRYO group was 87% vs. 93% for RF group (p= 0.34).

Conclusions:
There is a marginally significant benefit in favor of the cryoablative procedure compared to radiofrequency ablation in successful restoration of sinus rhythm at the immediate postoperative period. However, both procedures are equally efficient at one, three and twelve months post-operatively.