Comparison of Radiofrequency Ablation and Cryoablation for Paroxysmal Atrial Fibrillation：A Meta-Analysis of Randomized Controlled Trials. (Preprint)

BACKGROUND Some studies have compared the effects of radiofrequency current energy and cryoballoon in patients with paroxysmal atrial fibrillation. The results on the rate of atrial fibrillation and the incidence of complications one year after ablation were inconsistent with these studies. OBJECTIVE The purpose of this study was to evaluate whether the efficacy and safety of cryoballoon (CB) are better than that of radiofrequency ablation(RF) for pulmonary vein isolation in the treatment of paroxysmal atrial fibrillation(PAF). METHODS The Pubmed and Cochrane Library databases were searched for randomized controlled trials(RCTs) since inception through August 2020. The efficacy outcome was success rate one year after ablation. Rate of complications safety outcome. Included studies were RCTs in adults with PAF in which CB therapy was compared to RF therapy. Two investigators extracted data from the selected studies and assessed the risk of bias. RESULTS A total of 6 RCTs with 1681 individuals were included in the analysis. Pooled analyses indicated that CB ablation had a lower rate of the free-from atrial fibrillation(AF) one year after catheter ablation than RF therapy,but not statistically significant (OR: 0.88; 95% CI: 0.57 to 1.36;p=0.57). There was a higher rate of complications in the CB group,but not significant (OR: 1.27;95% CI: 0.73 to 2.22;p=0.39). CONCLUSIONS This meta-analysis shows that CB is not better than RF for patients with paroxysmal atrial fibrillation, and the incidence of complications is not lower than RF.