Cryoballoon ablation demonstrated a similar recurrence rate of atrial fibrillation compared to radiofrequency ablation (RR 0.84, 95% CI 0.65-1.07), while significantly reducing procedure and fluoroscopy times.
Meta-Analysis (n=3,527)
Does cryoballoon ablation reduce the recurrence rate of atrial fibrillation compared to radiofrequency ablation in patients with antiarrhythmic drug-refractory atrial fibrillation?
Cryoballoon ablation demonstrates similar efficacy to radiofrequency ablation for preventing atrial fibrillation recurrence, with the advantage of shorter procedure and fluoroscopy times, though it carries an exclusive risk of phrenic nerve palsy.
Effect estimate: RR 0.84 (95% CI 0.65, 1.07)
BACKGROUND: Ablation therapy is the treatment of choice in antiarrhythmic drugrefractory atrial fibrillation (AF). It is performed by either cryoballoon ablation (CBA) or radiofrequency ablation. CBA is gaining popularity due to simplicity with similar efficacy and complication rate compared with RFA. In this meta-analysis, we compare the recurrence rate of AF and the complications from CBA versus RFA for the treatment of AF. METHODS: We systematically searched PubMed for the articles that compared the outcome of interest. The primary outcome was to compare the recurrence rate of AF between CBA and RFA. We also included subgroup analysis with complications of pericardial effusion, phrenic nerve palsy and cerebral microemboli following ablation therapy. RESULTS: A total of 24 studies with 3527 patients met our predefined inclusion criteria. Recurrence of AF after CBA or RFA was similar in both groups (RR: 0.84; 95% CI: 0.65, 1.07; I2=48%, Cochrane p=0.16). In subgroup analysis, heterogeneity was less in paroxysmal AF (I2=0%, Cochrane p=0.46) compared to mixed AF (I2=72%, Cochrane p=0.003). Procedure and fluoroscopy time was less by 26.37 and 5.94 minutes respectively in CBA compared to RFA. Complications, pericardial effusion, and silent cerebral microemboli, were not different between the two groups, however, phrenic nerve palsy was exclusively present only in CBA group. CONCLUSION: This study confirms that the effectiveness of CBA is similar to RFA in the treatment of AF with the added advantages of shorter procedure and fluoroscopy times.
Patel et al. (Wed,) conducted a meta-analysis in Atrial Fibrillation (n=3,527). Cryoballoon Ablation vs. Radiofrequency Ablation was evaluated on Recurrence rate of atrial fibrillation (RR 0.84, 95% CI 0.65, 1.07). Cryoballoon ablation demonstrated a similar recurrence rate of atrial fibrillation compared to radiofrequency ablation (RR 0.84, 95% CI 0.65-1.07), while significantly reducing procedure and fluoroscopy times.