{"id":"87b2e9906a2c","type":"article","url":"https://hartvaat.nl/2021/07/18/cryoballonablatie-versus-antiaritmica-als-eerstelijns-paf-therapie/","title":"Cryoballonablatie versus antiaritmica als eerstelijns PAF-therapie","title_en":"Cryoballoon ablation vs. antiarrhythmic drugs: first-line therapy for patients with paroxysmal atrial fibrillation.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["cryoablatie"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euab029","source_url":"https://doi.org/10.1093/europace/euab029","authors":["Malte Kuniss","Nikola Pavlovic","Vedran Velagic","Jean Sylvain Hermida","Stewart Healey","Giuseppe Arena","Nicolas Badenco","Christian Meyer","Jian Chen","Saverio Iacopino","Frédéric Anselme","Douglas L Packer","Heinz-Friedrich Pitschner","Carlo de Asmundis","Stephan Willems","Fabio Di Piazza","Daniel Becker","Gian-Battista Chierchia"],"significance":6,"published":"2021-07-18","source_date":"2021-07-18","image":"","kennis":[],"congress":"","summary_en":"This study compared cryoballoon ablation with antiarrhythmic drugs as first-line therapy for paroxysmal AF, providing additional evidence for the ablation-first approach as the initial treatment strategy.","created":"2026-07-03T10:29:18Z","updated":"2026-07-03T13:28:26Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Vergelijking van cryoballonablatie versus antiaritmische medicatie als eerstelijns therapie voor paroxysmaal AF.","abstract_original":"AIMS: Treatment guidelines for patients with atrial fibrillation (AF) suggest that patients should be managed with an antiarrhythmic drug (AAD) before undergoing catheter ablation (CA). This study evaluated whether pulmonary vein isolation employing cryoballoon CA is superior to AAD therapy for the prevention of atrial arrhythmia (AA) recurrence in rhythm control naive patients with paroxysmal AF (PAF). METHODS AND RESULTS: A total of 218 treatment naive patients with symptomatic PAF were randomized (1 : 1) to cryoballoon CA (Arctic Front Advance, Medtronic) or AAD (Class I or III) and followed for 12 months. The primary endpoint was ≥1 episode of recurrent AA (AF, atrial flutter, or atrial tachycardia) >30 s after a prespecified 90-day blanking period. Secondary endpoints included the rate of serious adverse events (SAEs) and recurrence of symptomatic palpitations (evaluated via patient diaries). Freedom from AA was achieved in 82.2% of subjects in the cryoballoon arm and 67.6% of subjects in the AAD arm (HR = 0.48, P = 0.01). There were no group differences in the time-to-first (HR = 0.76, P = 0.28) or overall incidence [incidence rate ratio (IRR)=0.79, P = 0.28] of SAEs. The incidence rate of symptomatic palpitations was lower in the cryoballoon (7.61 days/year) compared with the AAD arm (18.96 days/year; IRR = 0.40, P < 0.001). CONCLUSIONS: Cryoballoon CA was superior to AAD therapy, significantly reducing AA recurrence in treatment naive patients with PAF. Additionally, cryoballoon CA was associated with lower symptom recurrence and a similar rate of SAEs compared with AAD therapy."}