Fire and Ice: For Atrial Fibrillation, Both Treatments Were Equivalent

Pulmonary vein isolation is the cornerstone of ablative management of atrial fibrillation (AF), with cryoablation a more recent addition than radiofrequency ablation. Both techniques were compared in a noninferiority, randomized trial sponsored by the cryoballoon manufacturer. Participants had paroxysmal AF refractory to at least one drug.

In all, 378 patients were assigned to cryoablation and 384 to radiofrequency ablation. Rate of acute isolation of pulmonary veins was 98.9% with cryoablation and 97.9% with radiofrequency ablation (see figure). Cryoablation had shorter procedure duration (124 vs. 141 minutes) and left atrial catheter dwell time (92 vs. 109 minutes) but longer fluoroscopy time (22 vs. 17 minutes; P<0.001 for all comparisons…