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 .
Point-by-Point Radiofrequency Ablation Versus the Cryoballoon or a Novel Combined Approach: A Randomized Trial Comparing 3 Methods of Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation (The Cryo Versus RF Trial).
INTRODUCTION Catheter ablation of paroxysmal AF using the Cryoballoon ( CRYO ) has yielded similar success rates to conventional wide encirclement using radiofrequency catheter ablation ( RFCA ) , but r and omized data are lacking . Pilot data suggested a high success rate with a combined approach ( COMBINED ) using wide encirclement with RFCA followed by 2 CRYO applications to each vein . We compared these 3 strategies in a r and omized controlled trial . METHODS AND RESULTS Patients undergoing first time paroxysmal AF ablation were r and omized to RFCA , CRYO , or COMBINED . Patients were followed up at 3 , 6 , and 12 months with 7 days of ambulatory ECG monitoring . Success was defined as freedom from arrhythmia without antiarrhythmic drugs after a single procedure . A total of 237 patients were r and omized . Success at 1 year was achieved in 47 % in the RFCA group , 67 % in the CRYO group , and 76 % in the COMBINED group ( P < 0.001 for RFCA vs. CRYO , P<0.001 for RFCA vs. COMBINED , and P = 0.220 for CRYO vs. COMBINED ) . Procedure time was 211 ( IQR 174 - 256 ) minutes for RFCA compared to 167 ( 136 - 202 ) minutes for CRYO and 278 ( 243 - 327 ) minutes for COMBINED ( P < 0.001 for RFCA vs. COMBINED , RFCA vs. CRYO , and CRYO vs. COMBINED groups ) . CONCLUSIONS Pulmonary vein isolation for paroxysmal AF is faster with CRYO and results in a higher single procedure success rate than conventional point by point RFCA . The COMBINED approach was not superior to CRYO alone
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 .