Pool analyses indicated that CB ablation was more beneficial in terms of procedural time [ st and ard mean difference = −0.58 ; 95 % confidence interval ( CI ) , −0.85 to −0.30 ] , complications without phrenic nerve injury ( PNI ) [ odds ratio ( OR ) = 0.79 ; 95 % CI , 0.67–0.93 ; I2 = 16 % ] , and recrudescence ( OR = 0.83 ; 95 % CI , 0.70–0.97 ; I2 = 63 % ) for PAF ; however , the total complications of CB was higher than RF .
The subgroup analysis found that , compared with non-contact force radiofrequency ( non-CF-RF ) , both first-generation cryoballoon ( CB1 ) and second-generation cryoballoon ( CB2 ) ablation  could reduce complications with PNI , procedural time , and recrudescence .
However , the safety and efficacy of CB2 was similar to those of CF-RF .
Conclusion Available overall and subgroup data suggested that both CB1 and CB2 were more beneficial than RF ablation , and the main advantages were reflected in comparing them with non-CF-RF .
However , CF-RF and CB2 showed similar clinical benefits
Purpose The present systematic review and meta- analysis aim ed to assess and compare the safety and efficacy of radiofrequency ( RF ) and cryoballoon ( CB ) ablation for paroxysmal atrial fibrillation ( PAF ) .
RF and CB ablation are two frequently used methods for pulmonary vein isolation in PAF , but which is a better choice for PAF remains uncertain .
MEDAFI-Trial (Micro-embolization during ablation of atrial fibrillation): comparison of pulmonary vein isolation using cryoballoon technique vs. radiofrequency energy.
AIMS Cerebral embolism is a possible serious complication during catheter ablation of atrial fibrillation ( AF ) .  The purpose of this prospect i ve pilot study was to analyse the incidence and possible impact of cryo ablation on cerebral lesions and possible differences to radiofrequency ( RF ) ablation during pulmonary vein isolation ( PVI ) . METHODS AND RESULTS Pulmonary vein isolation was performed in 89 patients , either with the cryoballoon technique ( n = 45 ) or with RF ablation ( n = 44 ) .  Phenprocoumon was stopped 3 days before intervention and replaced by subcutaneous low-molecular-weight heparin . During the catheter procedure , an infusion of unfractionated heparin was maintained to achieve an activated clotting time ( ACT ) of > 300 s. Cerebral magnetic resonance imaging scans were performed 1 day before and after PVI , and at 3-month follow-up . Chronic lesions were observed in 11 patients ( 12.3 % ) before PVI without statistically significant difference between the two groups . None of the patients had neurological symptoms during or following the procedure . Seven patients ( 7.9 % ) developed acute lesions 1 day after PVI , without statistically significant difference between the group treated by cryoenergy ( 8.9 % ) and RF ablation ( 6.8 % ) . Patients with acute lesions were significantly older compared with those without acute cerebral lesions . No additional cerebral lesions during follow-up were observed . CONCLUSION A considerable portion of patients with AF but without any neurological symptoms had chronic cerebral lesions before PVI . Additional acute lesions could be added after the procedure . Both ablation techniques showed additional cerebral acute lesions with no neurological symptoms after PVI
Pool analyses indicated that CB ablation was more beneficial in terms of procedural time [ st and ard mean difference = −0.58 ; 95 % confidence interval ( CI ) , −0.85 to −0.30 ] , complications without phrenic nerve injury ( PNI ) [ odds ratio ( OR ) = 0.79 ; 95 % CI , 0.67–0.93 ; I2 = 16 % ] , and recrudescence ( OR = 0.83 ; 95 % CI , 0.70–0.97 ; I2 = 63 % ) for PAF ; however , the total complications of CB was higher than RF .
The subgroup analysis found that , compared with non-contact force radiofrequency ( non-CF-RF ) , both first-generation cryoballoon ( CB1 ) and second-generation cryoballoon ( CB2 ) ablation  could reduce complications with PNI , procedural time , and recrudescence .
However , the safety and efficacy of CB2 was similar to those of CF-RF .
Conclusion Available overall and subgroup data suggested that both CB1 and CB2 were more beneficial than RF ablation , and the main advantages were reflected in comparing them with non-CF-RF .
However , CF-RF and CB2 showed similar clinical benefits
Purpose The present systematic review and meta- analysis aim ed to assess and compare the safety and efficacy of radiofrequency ( RF ) and cryoballoon ( CB ) ablation for paroxysmal atrial fibrillation ( PAF ) .
RF and CB ablation are two frequently used methods for pulmonary vein isolation in PAF , but which is a better choice for PAF remains uncertain .