Efficacy and safety of cryoballoon ablation versus radiofrequency catheter ablation in atrial fibrillation: an updated meta-analysis

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Atrial fibrillation (n=9141). Intervention: Cryoballoon ablation vs. Radiofrequency catheter ablation. Primary outcome: Freedom from atrial fibrillation (OR 1.15, 95% CI 0.95-1.39, p=0.14).

Honglan Ma; Dongdong Sun; Hui Luan; Wei Feng; Yaqiong Zhou; Jine Wu; Caiyun He; Chaofeng Sun

doi:10.5114/aic.2017.70196

January 1, 2017Advances in Interventional CardiologyOpen Access

Efficacy and safety of cryoballoon ablation versus radiofrequency catheter ablation in atrial fibrillation: an updated meta-analysis

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Key result

Cryoballoon ablation showed similar freedom from atrial fibrillation compared to radiofrequency catheter ablation, with shorter procedure times but higher risk of phrenic nerve paralysis.

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Why the study?

Does cryoballoon ablation improve efficacy and safety compared to radiofrequency catheter ablation in patients with drug-refractory symptomatic atrial fibrillation?

Study Design

Type

Meta-Analysis (n=9,141)

Structured PICO

Does cryoballoon ablation improve efficacy and safety compared to radiofrequency catheter ablation in patients with drug-refractory symptomatic atrial fibrillation?

P

Population

Patients with drug-refractory symptomatic atrial fibrillation (AF)

I

Intervention

Cryoballoon ablation (CBA)

C

Comparator

Irrigated radiofrequency catheter ablation (RFCA)

O

Outcome

Efficacy and safety

Main Result

Effect estimate: OR 1.15 (95% CI 0.95-1.39)

Absolute Event Rate: 78.55% vs 83.13%

p-value: p=0.14

Cryoballoon ablation offers similar efficacy to radiofrequency ablation for atrial fibrillation, with shorter procedure times but a different safety profile (higher phrenic nerve palsy, lower pericardial effusion).

Limitations

Several studies were designed in receiver operating characteristic curve, which might increase selection bias.
Small trials (number of patients < 20) and non-English published studies were excluded.
Unpublished data such as those presented at scientific meetings in abstract form were not included.
Data of procedure and fluoroscopy times were not all recorded as mean (standard deviation).
Almost all included studies did not record the institutional level of experience with either ablation catheter.

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Implication

Cryoballoon ablation remains a viable option for drug-refractory AF; reinforces comparable efficacy to radiofrequency with distinct procedural trade-offs.

Abstract

INTRODUCTION: Cryoballoon ablation (CBA) and irrigated radiofrequency catheter ablation (RFCA) are the main treatments for drug-refractory symptomatic atrial fibrillation (AF). AIM: To compare the efficacy and safety between CBA and RFCA for the treatment of AF. MATERIAL AND METHODS: We searched the Embase and Medline databases for clinical studies published up to December 2016. Studies that satisfied our predefined inclusion criteria were included. CONCLUSIONS: For AF, CBA was as effective as RFCA. However, CBA had a shorter procedure time and a non-significantly shorter fluoroscopy time, a significantly high risk of PNP and a low incidence of pericardial effusions/cardiac tamponade compared with RFCA.

Discussion

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Cite This Study

Ma et al. (2017) conducted a meta-analysis in Atrial fibrillation (n=9,141). Cryoballoon ablation vs. Radiofrequency catheter ablation was evaluated on Freedom from atrial fibrillation (OR 1.15, 95% CI 0.95-1.39, p=0.14). Cryoballoon ablation showed similar freedom from atrial fibrillation compared to radiofrequency catheter ablation, with shorter procedure times but higher risk of phrenic nerve paralysis.

synapsesocial.com/papers/6a11de308793652519a57356 https://doi.org/10.5114/aic.2017.70196

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Efficacy and safety of cryoballoon ablation versus radiofrequency catheter ablation in atrial fibrillation: an updated meta-analysis

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Efficacy and safety of cryoballoon ablation versus radiofrequency catheter ablation in atrial fibrillation: an updated meta-analysis

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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