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June 7, 2026Cardiology ResearchOpen Access

Single-freezing AF cryoablation maintains similar sinus rhythm vs conventional TTI protocols while reducing procedure time.

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Why the study?

The study aimed to compare the efficacy and safety of a simplified single-freezing protocol versus the conventional time-to-isolation-guided double-freezing protocol using second-generation cryoballoon in AF.

Does a single-freezing temperature-guided protocol improve procedural efficiency without compromising efficacy compared to a conventional TTI-guided protocol in patients undergoing AF cryoablation?

Comparison

Simplified single-freezing temperature-guided protocol vs conventional TTI-guided double-freezing protocol

Design

Retrospective propensity score-matched analysis

Key result

A single-freezing temperature-guided protocol for AF cryoablation maintained sinus rhythm similarly to a conventional TTI-guided protocol (74.7% vs 78.1%, P=0.842) while reducing procedure time.

Authors

XLXiaoyu LiuWuxi People's HospitalJZJie ZhengShanxi Medical UniversityKLKu Lin LiWuxi People's Hospital

Discussion

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Overview

Should not yet change AF cryoablation practice; leaves open whether simplified protocols improve efficiency without compromising outcomes in randomized trials.

Key Points

  • The study aims to compare the efficacy and safety of single-freezing versus conventional time-to-isolation protocols in atrial fibrillation ablation.
  • Retrospective analysis of 292 patients after propensity score matching.
  • Comparative assessment of procedure time, X-ray time, and complications between two protocols.
  • Analysis included success rate and recurrence rate during follow-up.
  • Simplified protocol reduced procedure time (79.4 vs 98.8 min, P<0.001) and X-ray exposure (17.8 vs 24.3 min, P<0.001).
  • No significant difference in success rate of isolation (145/146 vs 146/146, P=0.975).
  • Recurrence rate not predicted by the single-freezing protocol.

Study Design

Type

Cohort (n=292)

Structured PICO

Does a single-freezing temperature-guided protocol improve procedural efficiency without compromising efficacy compared to a conventional TTI-guided protocol in patients undergoing AF cryoablation?

P
Population
292 propensity score-matched patients undergoing atrial fibrillation ablation using a second-generation cryoballoon.
E
Exposure
Simplified single-freezing temperature-guided protocol (achieving -40 °C within 60 s of freezing) using second-generation cryoballoon
C
Comparator
Conventional time-to-isolation (TTI)-guided double-freezing protocol using second-generation cryoballoon
O
Outcome
Procedure time, X-ray time and dose, complications, success rate of acute pulmonary vein isolation, and recurrence rate during follow-up

Main Result

Absolute Event Rate: 74.7% vs 78.1%

p-value: p=0.842

A simplified single-freezing temperature-guided protocol for AF cryoablation reduces procedure time and radiation exposure while maintaining comparable efficacy to the conventional double-freezing protocol.

Cite This Study

Liu et al. (2026) conducted a cohort in Atrial fibrillation (n=292). Single-freezing temperature-guided protocol vs. Conventional time-to-isolation (TTI)-guided double-freezing protocol was evaluated on Maintaining sinus rhythm during follow-up (p=0.842). A single-freezing temperature-guided protocol for AF cryoablation maintained sinus rhythm similarly to a conventional TTI-guided protocol (74.7% vs 78.1%, P=0.842) while reducing procedure time.

synapsesocial.com/papers/6a2510017def13d035e1d45chttps://doi.org/10.14740/cr2202
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