Cryoballoon versus RF ablation in paroxysmal atrial fibrillation: results from the German Ablation Registry
Abstract
BACKGROUND: Catheter ablation is used extensively with curative intention in atrial fibrillation. Radiofrequency ablation has long been a standard of care, while cryoballoon technology has emerged as a feasible approach with promising results. Prospective multicenter registry data referring to both ablation technologies in AF ablation therapy are lacking. METHODS: Between January 2007 and August 2011, a total of 3,775 consecutive patients with symptomatic paroxysmal AF who underwent PV ablation in their respective centers were enrolled. The cohort was divided into 2 groups according to the ablation energy source used: cryoballoon ablation (group 1, n = 905 [24.0%], median age 63 years, 64.3% men) and RF ablation (group 2, n = 2870 [76.0%], median age 63 years, 62.7% men). Comorbidities and baseline clinical characteristics were similar in both groups. RESULTS: Acute success rate was similar in both groups (97.5% in cryo vs 97.6% in RF; P = 0.81). Procedure times were similar, ablation and fluoroscopy times were higher in cryoballoon when compared to RF ablation. Overall complication rate was similar in cryo- (4.6%) and RF-ablation (4.6%; P = 1.0). Phrenic nerve palsy was more often in cryo versus RF ablation (2.1% in cryo vs 0.0% in RF; P < 0.001). Other complications were more common in RF compared to cryoablation (4.6% in RF vs 2.7% in cryo; P < 0.05). CONCLUSION: RF ablation is the most widespread ablation method in Germany, but use of cryoballoon increased significantly. Procedure times were similar, but ablation and fluoroscopy times were longer in cryoballoon ablation. No significant differences were found in terms of acute success and overall complication rate.
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Pulmonary vein isolation is achievable by point-by-point radiofrequency ablation, linear lesions encircling the pulmonary veins, or cryoballoon ablation, with similar outcomes.
“achievable by point-by-point radiofrequency ablation, linear lesions encircling the pulmonary veins, or cryoballoon ablation, with similar outcomes.[732][733][734]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [733]
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The Hot and the Cold: Radiofrequency Versus Cryoballoon Ablation for Atrial Fibrillation
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Radiofrequency versus cryoballoon ablation for atrial fibrillation
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- Authors
- SCHMIDT, M., DORWARTH, U., ANDRESEN, D., BRACHMANN, J., KUCK, K., KUNISS, M., LEWALTER, T., SPITZER, S., WILLEMS, S., SENGES, J., JÜNGER, C., & HOFFMANN, E.
- Affiliations
- München Klinik Bogenhausen (DE)
- Vivantes Klinikum (DE)
- Klinikum Coburg (DE)
- Department of Cardiology Asklepios Klinik St. Georg Hamburg Germany
- Kerckhoff Klinik (DE)
- TUM Klinikum (DE)
- Praxisklinik Herz und Gefäße Dresden Germany
- Universität Hamburg (DE)
- Stiftung Institut für Herzinfarktforschung (DE)
- Corresponding author
- SCHMIDT, MARTIN
- ORCID
- Venue
- Journal of Cardiovascular Electrophysiology
- Publisher
- Wiley
- Published
- 2013-10-17
- Volume
- 25
- Issue
- 1
- Pages
- 1-7
- ISSN
- 1045-3873 (ISSN-L)
- 1540-8167
- OpenAlex
- W1813436278
- Cited by
- 126
- References
- 33
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 5 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 10 · 2019: 5 · 2018: 10 · 2017: 12 · 2016: 22 · 2015: 21 · 2014: 20 · 2013: 2
- FWCI
- 14.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiovascular Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Stiftung Institut für Herzinfarktforschung Ludwigshafen, Germany
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- paroxysmal atrial fibrillation, cryoballoon ablation, radiofrequency ablation, catheter ablation, pulmonary vein ablation, procedural success, procedural complications, phrenic nerve palsy, fluoroscopy time
- MeSH terms
- Aged, Atrial Fibrillation, Cryosurgery, Female, Germany, Humans, Male, Middle Aged, Prospective Studies, Registries, Cohort Studies, Catheter Ablation
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