Cryoballoon versus radiofrequency ablation for persistent atrial fibrillation: an updated systematic review and meta‑analysis
Abstract Background Compared with paroxysmal atrial fibrillation, persistent atrial fibrillation (AF) is more harmful and difficult to treat, and the efficacy of different catheter ablation for both also varies greatly. So this study aimed to systematically evaluate the efficacy and safety of cryoba...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
|
| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-025-02911-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849344157582098432 |
|---|---|
| author | Yi-Meng Gao Tian-Zhi Cai Hong-Lan Ma |
| author_facet | Yi-Meng Gao Tian-Zhi Cai Hong-Lan Ma |
| author_sort | Yi-Meng Gao |
| collection | DOAJ |
| description | Abstract Background Compared with paroxysmal atrial fibrillation, persistent atrial fibrillation (AF) is more harmful and difficult to treat, and the efficacy of different catheter ablation for both also varies greatly. So this study aimed to systematically evaluate the efficacy and safety of cryoballoon (CB) and radiofrequency (RF) ablation in the treatment of persistent AF. Methods We searched the PubMed, Embase, and Cochrane library databases for studies comparing the efficacy and safety between CB and RF ablation for persistent AF. All included studies met our inclusion criteria. Results A total of 11 studies, 2551 patients were enrolled in this study, including 1256 patients in CB group and 1295 patients in RF group. Meta-analysis results showed that the freedom from atrial tachyarrhythmia (ATA) recurrence was similar between the CB and RF groups (OR 1.00, 95% CI 0.85 to 1.18, I 2 16%). The results of repeated ablation events in the two groups were similar (OR 0.85, 95% CI 0.64 to 1.12, I 245%), while the operative time in the CB group was shorter than that in the RF group (mean reduction 45.27 min, 95% CI 61.34 to 29.20 min, I 2 95%). There was no significant difference in fluoroscopy time between the two groups (mean difference 2.12 min, 95% CI 7.83 to 12.07 min, I 2 99%). The incidence of total complications was similar between the two groups (OR 1.08, 95% CI 0.74 to 1.58, I 2 0%), but phrenic nerve palsy (PNP) was more likely to occur in the CB group (OR 4.84, 95% CI 1.84 to 12.71, I 2 0%). The incidence of pericardial tamponade was not statistically different between the two groups (OR 0.72, 95% CI 00.32 to 1.58, I 2 0%). Conclusions CB can be used as an alternative therapy to RF for persistent AF, both of which have considerable efficacy and safety. CB can significantly reduce the operation time with the probability of high PNP. |
| format | Article |
| id | doaj-art-d04c865c6baa4955b7b8ba1686478b13 |
| institution | Kabale University |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-d04c865c6baa4955b7b8ba1686478b132025-08-20T03:42:44ZengBMCEuropean Journal of Medical Research2047-783X2025-07-0130111110.1186/s40001-025-02911-xCryoballoon versus radiofrequency ablation for persistent atrial fibrillation: an updated systematic review and meta‑analysisYi-Meng Gao0Tian-Zhi Cai1Hong-Lan Ma2Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Medical UniversityDepartment of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Medical UniversityDepartment of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Medical UniversityAbstract Background Compared with paroxysmal atrial fibrillation, persistent atrial fibrillation (AF) is more harmful and difficult to treat, and the efficacy of different catheter ablation for both also varies greatly. So this study aimed to systematically evaluate the efficacy and safety of cryoballoon (CB) and radiofrequency (RF) ablation in the treatment of persistent AF. Methods We searched the PubMed, Embase, and Cochrane library databases for studies comparing the efficacy and safety between CB and RF ablation for persistent AF. All included studies met our inclusion criteria. Results A total of 11 studies, 2551 patients were enrolled in this study, including 1256 patients in CB group and 1295 patients in RF group. Meta-analysis results showed that the freedom from atrial tachyarrhythmia (ATA) recurrence was similar between the CB and RF groups (OR 1.00, 95% CI 0.85 to 1.18, I 2 16%). The results of repeated ablation events in the two groups were similar (OR 0.85, 95% CI 0.64 to 1.12, I 245%), while the operative time in the CB group was shorter than that in the RF group (mean reduction 45.27 min, 95% CI 61.34 to 29.20 min, I 2 95%). There was no significant difference in fluoroscopy time between the two groups (mean difference 2.12 min, 95% CI 7.83 to 12.07 min, I 2 99%). The incidence of total complications was similar between the two groups (OR 1.08, 95% CI 0.74 to 1.58, I 2 0%), but phrenic nerve palsy (PNP) was more likely to occur in the CB group (OR 4.84, 95% CI 1.84 to 12.71, I 2 0%). The incidence of pericardial tamponade was not statistically different between the two groups (OR 0.72, 95% CI 00.32 to 1.58, I 2 0%). Conclusions CB can be used as an alternative therapy to RF for persistent AF, both of which have considerable efficacy and safety. CB can significantly reduce the operation time with the probability of high PNP.https://doi.org/10.1186/s40001-025-02911-xPersistent atrial fibrillationCryoballoon ablationRadiofrequency ablationMeta-analysis |
| spellingShingle | Yi-Meng Gao Tian-Zhi Cai Hong-Lan Ma Cryoballoon versus radiofrequency ablation for persistent atrial fibrillation: an updated systematic review and meta‑analysis European Journal of Medical Research Persistent atrial fibrillation Cryoballoon ablation Radiofrequency ablation Meta-analysis |
| title | Cryoballoon versus radiofrequency ablation for persistent atrial fibrillation: an updated systematic review and meta‑analysis |
| title_full | Cryoballoon versus radiofrequency ablation for persistent atrial fibrillation: an updated systematic review and meta‑analysis |
| title_fullStr | Cryoballoon versus radiofrequency ablation for persistent atrial fibrillation: an updated systematic review and meta‑analysis |
| title_full_unstemmed | Cryoballoon versus radiofrequency ablation for persistent atrial fibrillation: an updated systematic review and meta‑analysis |
| title_short | Cryoballoon versus radiofrequency ablation for persistent atrial fibrillation: an updated systematic review and meta‑analysis |
| title_sort | cryoballoon versus radiofrequency ablation for persistent atrial fibrillation an updated systematic review and meta analysis |
| topic | Persistent atrial fibrillation Cryoballoon ablation Radiofrequency ablation Meta-analysis |
| url | https://doi.org/10.1186/s40001-025-02911-x |
| work_keys_str_mv | AT yimenggao cryoballoonversusradiofrequencyablationforpersistentatrialfibrillationanupdatedsystematicreviewandmetaanalysis AT tianzhicai cryoballoonversusradiofrequencyablationforpersistentatrialfibrillationanupdatedsystematicreviewandmetaanalysis AT honglanma cryoballoonversusradiofrequencyablationforpersistentatrialfibrillationanupdatedsystematicreviewandmetaanalysis |