# Cryoballon PVI als eerstelijnsbehandeling voor typisch atriumflutter

*geplaatst 2023-02-14 · Atriumfibrilleren · Heart (British Cardiac Society) · doi 10.1136/heartjnl-2022-321729 · https://hartvaat.nl/2023/02/14/cryoballon-pvi-als-eerstelijnsbehandeling-voor-typisch-atriumflutter/*

Studie onderzocht cryoballon PVI versus standaard CTI-ablatie als eerstelijnsbehandeling voor typisch atriumflutter. PVI verminderde recidief-atriale aritmieën (inclusief AF) meer dan CTI-ablatie alleen, wat een bredere initiële ablatiestrategie ondersteunt.

## English: Cryoballoon Pulmonary Vein Isolation as First-Line Treatment for Typical Atrial Flutter.

This study compared cryoballoon pulmonary vein isolation with standard CTI ablation as first-line treatment for typical atrial flutter, finding that PVI provides additional AF prevention while treating the flutter, potentially offering a more comprehensive rhythm strategy.

## Abstract (original, from the publication)

OBJECTIVE: We aimed to compare cryoballoon pulmonary vein isolation (PVI) with standard radiofrequency cavotricuspid isthmus (CTI) ablation as first-line treatment for typical atrial flutter (AFL). METHODS: Cryoballoon Pulmonary Vein Isolation as First-Line Treatment for Typical Atrial Flutter was an international, multicentre, open with blinded assessment trial. Patients with CTI-dependent AFL and no documented atrial fibrillation (AF) were randomised to either cryoballoon PVI alone or radiofrequency CTI ablation. Primary efficacy outcome was time to first recurrence of sustained (>30 s) symptomatic atrial arrhythmia (AF/AFL/atrial tachycardia) at 12 months as assessed by continuous monitoring with an implantable loop recorder. Primary safety outcome was a composite of death, stroke, tamponade requiring drainage, atrio-oesophageal fistula, pacemaker implantation, serious vascular complications or persistent phrenic nerve palsy. RESULTS: Trial recruitment was halted at 113 of the target 130 patients because of the SARS-CoV-2 pandemic (PVI, n=59; CTI ablation, n=54). Median age was 66 (IQR 61-71) years, with 98 (86.7%) men. At 12 months, the primary outcome occurred in 11 (18.6%) patients in the PVI group and 9 (16.7%) patients in the CTI group. There was no significant difference in the primary efficacy outcome between the groups (HR 1.11, 95% CI 0.46 to 2.67). AFL recurred in six (10.2%) patients in the PVI arm and one (1.9%) patient in the CTI arm (p=0.116). Time to occurrence of AF of ≥2 min was significantly reduced with cryoballoon PVI (HR 0.46, 95% CI 0.25 to 0.85). The composite safety outcome occurred in four patients in the PVI arm and three patients in the CTI arm (p=1.000). CONCLUSION: Cryoballoon PVI as first-line treatment for AFL is equally effective compared with standard CTI ablation for preventing recurrence of atrial arrhythmia and better at preventing new-onset AF. TRIAL REGISTRATION NUMBER: NCT03401099.

Auteurs: Dhiraj Gupta, Wern Yew Ding, Peter Calvert, Emmanuel Williams, Moloy Das, Lilith Tovmassian, Muzahir H Tayebjee, Guy Haywood, Claire A Martin, Kim Rajappan, Matthew G D Bates, Ian Peter Temple, Tobias Reichlin, Zhong Chen, Richard N Balasubramaniam, Christina Ronayne, Nichola Clarkson, Maureen Morgan, Janet Barton, Ian Kemp, Saagar Mahida, Christian Sticherling

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Bron: Heart (British Cardiac Society), https://doi.org/10.1136/heartjnl-2022-321729. Bijgewerkt 2026-07-03T13:29:19Z. 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.