Patient-Reported Outcomes After First Pulmonary Vein Isolation for ParoxYsmal Atrial Fibrillation: Cryoballoon vs....

Area of Science:

• Cardiology
• Medical Technology
• Patient Outcomes

Background:

• Patient-reported outcomes are crucial for evaluating healthcare quality and influencing future patient decisions.
• Radiofrequency ablation (RFA) and cryoballoon ablation (CBA) are established treatments for atrial fibrillation (AF) with comparable efficacy and safety.
• A direct comparison of patient satisfaction between RFA and CBA following initial pulmonary vein isolation is lacking.

Purpose of the Study:

• To compare patient satisfaction in patients with paroxysmal atrial fibrillation (AF) undergoing their first pulmonary vein isolation procedure using either RFA or CBA.
• To evaluate patient-reported outcomes including anxiety, pain, procedural time perception, and willingness to repeat the procedure.

Main Methods:

• A prospective study involving 483 consecutive patients undergoing their first pulmonary vein isolation (PVI) via RFA or CBA across eight international centers.
• Patient-reported outcomes were assessed using a ten-point Likert scale, focusing on pre-procedural anxiety, pain during/after ablation, motivation to repeat, and perceived procedural duration.
• Data were analyzed comparing RFA and CBA groups, and also considering the impact of anesthetic management (conscious sedation vs. general anesthesia).

Main Results:

• Overall patient satisfaction was similar between RFA and CBA, with lower groin pain reported in the CBA group (p=0.002).
• General anesthesia, compared to conscious sedation, reduced perceived pain for both techniques but only lowered pre-procedural anxiety in the RFA group.
• Patients undergoing CBA under general anesthesia showed a higher motivation to repeat the procedure compared to those under conscious sedation (p<0.001).

Conclusions:

• Anesthetic management appears to exert a more significant influence on patient-reported outcomes than the specific ablation technique (RFA vs. CBA).
• While both techniques yield comparable satisfaction, CBA under general anesthesia was associated with the highest patient motivation for future procedures.
• Perceived procedural time was consistently shorter than actual time across all patient groups and techniques.