Cryoablation of atrial fibrillation

Atrial fibrillation (AF) is a significant burden to the public health. AF is associated with increased morbidity and mortality, including an increased risk of heart failure, stroke, cognitive impairment, and diminished quality of life. Catheter ablation is an effective therapy for recurrent, symptomatic, drug-refractory AF. To date, radiofrequency ablation has been the most common catheter-based method of pulmonary vein isolation; however, there is increasing interest in cryoablation. Emerging evidence from both observational and randomized studies suggests that cryoablation of AF is a reasonable alternative to radiofrequency ablation, with comparable safety and efficacy. The goal of this narrative review will be to trace the development of cryoablation for AF, summarize the available evidence base for both the safety and efficacy of the procedure, and finally to discuss the relative advantages and disadvantages of cryoablation versus radiofrequency ablation.