Head-to-head: Cryoballoon vs radiofrequency ablation in persistent AF

Cryoballoon ablation and radiofrequency ablation had similar atrial tachyarrhythmia outcomes at 1-year post-ablation in patients with persistent atrial fibrillation (AF). However, findings from the randomised controlled CRRF-PeAF trial indicated that radiofrequency ablation has a more substantial reversed remodelling effect than cryoballoon ablation.

The CRRF-PeAF trial compared cryoballoon and radiofrequency ablation in a large cohort of patients with persistent AF. The 500 participants were randomised 1:1 to cryoballoon ablation or to radiofrequency ablation. The primary endpoint was the occurrence of atrial tachyarrhythmias at 1 year of follow-up. Dr Kengo Kusano (National Cerebral and Cardiovascular Center, Japan) presented the results [1].

No difference was seen between the 2 arms with respect to the primary endpoint (HR 0.99; 95% CI 0.69–1.43; P_log-rank=0.96). This finding was consistent across subgroups. “We did, however, see a significant reduction in left atrial volume index in the radiofrequency group as compared with the cryoballoon group at 1-year post-ablation, suggesting that the 2 ablation techniques have a different impact on reverse remodelling,” added Dr Kusano.

“Cryoballoon and radiofrequency ablation yielded similar arrhythmia outcomes in patients with persistent AF,” concluded Dr Kusano. “Although we know that cryoballoon ablation has a shorter procedure time than radiofrequency ablation, the latter was associated with inducing more profound structural changes to the left atrium.”

1. 
   
   1. Kusano K, et al. Cryoballoon ablation versus radiofrequency ablation in patients with persistent atrial fibrillation (CRRF-PEAF): a prospective, multicenter, randomized, non-inferiority clinical trial. LBS.07, AHA Scientific Sessions 2024, 16–18 November, Chicago, USA.

Medical writing support was provided by Robert van den Heuvel.
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Posted on 19 November 202419 November 2024