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

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.
(Copyright 2010 Elsevier Masson SAS. All rights reserved.)