German Ablation Registry: Cryoballoon vs. Radiofrequency Ablation in Paroxysmal Atrial fibrillation--One-year Outcome Data

Heart Rhythm. 2016 Apr;13(4):836-44. doi: 10.1016/j.hrthm.2015.12.007. Epub 2015 Dec 8.


Background: Although radiofrequency (RF) ablation has long been the standard of care for atrial fibrillation (AF) ablation, cryoballoon technology has emerged as a feasible approach with promising results. Prospective multicenter registry data referring to both ablation technologies in AF ablation are lacking so far.

Objective: The purpose of this study was to report data from the German ablation registry with respect to efficacy and safety in pulmonary vein ablation with different energy sources for paroxysmal AF after 1-year follow-up.

Methods: A total of 2306 patients with symptomatic paroxysmal AF from the German ablation registry were included in this analysis. The cohort was divided into two groups according to the ablation energy source used: cryoballoon and RF ablation. MACCE was defined as a combination of death, myocardial infarction, or stroke.

Results: AF recurrence rate after a single ablation procedure at 1 year follow-up was not significantly different between the two groups (45.8% after cryoablation and 45.4% after RF ablation, P = .87). Also, the rate of patients without AF recurrence and free of antiarrhythmic drug at 12-month follow-up was similar (cryoablation 44.2% and RF 41.4%, P = .25). MACCE occurred with an incidence of 0.7% within 500 days after cryoablation and 1.4% after RF ablation (P = .30). Persistent phrenic nerve palsy was more common after cryoablation compared to RF ablation (1.1% vs. 0.3%, P <.05).

Conclusion: AF recurrence rate at 1-year follow-up was similar in RF ablation compared to cryoablation, whereas the spectrum and relevance of complications were significantly different between the two ablation methods. This finding might influence the choice of ablation method offered to the individual paroxysmal AF patient.

Keywords: Atrial fibrillation ablation; Cryoballoon; Efficacy; Radiofrequency ablation; Registry; Safety.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / methods*
  • Cryosurgery / methods*
  • Disease-Free Survival
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Heart Conduction System / physiopathology
  • Heart Conduction System / surgery*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Prognosis
  • Prospective Studies
  • Recurrence
  • Registries*
  • Survival Rate / trends
  • Tachycardia, Paroxysmal / physiopathology
  • Tachycardia, Paroxysmal / surgery*
  • Treatment Outcome