Comparison Of Cryoballoon And Radiofrequency Ablation In Treatment Of Atrial Fibrillation A Meta-analysis

Objective:The two most commonly used methods for the treatment of pulmonary vein isolation by catheter ablaton in paroxysmal atrial fibrillation are radiofrequency ablation and cryoballoon ablation.However,for patients with paroxysmal atrial fibrillation(PAF),it is still not clear which one is a better choice.We did a meta-analysis of randomized controlled trials to assess the safety and long-term efficacy of cryoballoon ablation and radiofrequency ablation in patients with PAF.Methods:In October 2018,we conducted a systematic search of PubMed,the Cochrane Library Database,and China National Knowledge Infrastructure(CNKI),including systematic reviews and randomized controlled trials,reporting safety,effectiveness,technical performance results at follow-up at least 12 months.Three researchers independently assessed eligibility for inclusion and methodological quality of all included studies.Results:A total of 7 randomized controlled trials were included-1529 patients were included.Meta-analysis results showed no difference between cryoballoon and radiofrequency in terms of recurrent atrial fibrillation(RR1.05,95% CI 0.98~1.12)or atrial tachyarrhythmia(RR1.03,95% CI 0.93~1.14)in the 12 th month after single ablation and fluoroscopy time(MD-3.14,95% CI-10.38~4.11)and pericardial effusion/cardiactamponade(RR0.37,95%CI 0.11~1.26).Cryoballoon ablation was associated with shorter total procedural time(MD-12.57,95% CI-23.35~-1.79),but with higher incidence of phrenic nerve palsy(RR10.98,95%CI3.33~36.19).Conclusion:In patients with PAF,there is no significant difference in the long-term efficacy of cryoballoon ablation and radiofrequency ablation in terms of freedom from recurrent atrial fibrillation or atrial tachyarrhythmias,but with different safety,cryoballoon ablation is more likely to cause phrenic nerve palsy(PNP).