Related Experiment Video
Updated: Jul 28, 2026
Direct Pressure Monitoring Accurately Predicts Pulmonary Vein Occlusion During Cryoballoon Ablation
Published on: February 26, 2013
Long-Term Results of the Effectiveness of Cryoballoon and Radiofrequency Ablation in Patients with Atrial
S M Gyulmamedova1, B Sh Berdibekov1, N I Bulaeva1
1Bakulev National Medical Research Cener for Cardiovascular Surgery.
Insights
Cryoballoon ablation (CBA) is more effective than radiofrequency ablation (RFA) for long-term atrial fibrillation (AF) treatment. Higher BMI and early recurrence predict late AF recurrence after catheter ablation.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia requiring effective treatment.
- Catheter ablation (CA) is a standard treatment for AF.
- Comparing cryoballoon ablation (CBA) and radiofrequency ablation (RFA) is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the long-term effectiveness of CBA and RFA in patients with atrial fibrillation (AF).
- To identify predictors of late AF recurrence after catheter ablation.
Main Methods:
- Retrospective single-site study of 597 AF patients undergoing CBA (n=241) or RFA (n=356).
- Propensity score matching (PSM) used to minimize confounding (234 pairs).
- Kaplan-Meier curves and Cox regression analysis employed to assess recurrence and predictors.
Main Results:
- After PSM, late AF recurrence was significantly lower after CBA (17.5%) compared to RFA (36.3%) (p<0.001).
- At 48 months, AF recurrence-free rates were 70% for CBA vs. 53% for RFA (p=0.005).
- Independent predictors of late AF recurrence included higher BMI and early AF recurrence within 90 days.
Conclusions:
- CBA demonstrates superior long-term efficacy compared to RFA for treating AF.
- Body mass index and early AF recurrence are significant independent predictors of late recurrence post-ablation.
Abstract:
Aim To compare the long-term effectiveness of cryoballoon ablation (CBA) and radiofrequency ablation (RFA) in patients with atrial fibrillation (AF).Material and methods This retrospective single-site study included 597 patients with AF who had undergone CBA (n=241) or RFA (n=356) between 2016 and 2024. The study participants included 355 men (59.5%) and 242 women (40.5%) aged 58.4±10.8 years. The follow-up period was 13.0 [10.0; 27.5] months. The primary endpoint was late recurrence of AF (≥90 days after catheter ablation (CA)) confirmed by electrocardiography (ECG) or ECG Holter monitoring. To minimize confounding, the groups were compared by the propensity score matching (PSM, 234 pairs). The absence of AF recurrence was analyzed using Kaplan-Meier survival curves and group comparison with the log-rank test. Predictors for an increased risk of AF recurrence were identified by the univariate and multivariate Cox regression analysis. Results With the use of PSM, late AF recurrence was found in 41 (17.5%) patients after CBA and in 85 (36.3%) after RFA (p<0.001). Thus, at 48 months after CA, AF recurrence was absent in 70% of patients in the CBA group and 53% patients in the RFA group; the difference between the groups was statistically significant (log-rank p=0.005). In the multivariate Cox analysis, independent predictors of AF recurrence were body mass index (BMI) (odds ratio (OR) 1.11; 95% confidence interval (CI) 1.05-1.18; p<0.001) and early AF recurrence within 90 days (OR 4.43; 95% CI 2.72-7.21; p<0.001). Conclusion According to the study univariate analysis, CBA showed an advantage over RFA in terms of the efficacy in the long-term period. Body mass index and early AF recurrence were independent predictors of late AF recurrence after CA.
