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 .
Transvenous cryoablation reduces platelet activation during pulmonary vein ablation compared with radiofrequency energy in patients with atrial fibrillation.
BACKGROUND Radiofrequency ( RF ) ablation procedures for atrial fibrillation ( AF ) are associated with potential risks of thromboembolism , which may be minimized by the use of cryoablation that preserves the integrity of endocardium . The objective of this study was to compare the thrombogenic potential of transvenous cryoablation versus RF ablation during pulmonary vein ( PV ) isolation . METHODS AND RESULTS Thirty consecutive patients with paroxysmal AF were r and omized to undergo segmental PV isolation procedure using 4-mm tip RF ablation ( n = 15 ) or cryoablation ( CryoCor , San Diego , CA , USA ) ( n = 15 ) . Blood sample s were drawn after sheath insertion ( baseline ) , after transseptal puncture , before ablation ( after heparin administration ) , and after isolation of a superior PV . Activation of coagulation was measured with plasma levels of prothrombin fragment 1 + 2 ( F1 + 2 ) and thrombin-antithrombin III complex ( TAT ) , and platelets by plasma level of beta-thromboglobulin ( beta-TG ) and flow cytometric enumerating of P-selectin (CD62)-positive platelets . In both groups , the plasma level of beta-TG , F1 + 2 , and TAT were elevated after sheath insertion . The percentage changes in plasma level of beta-TG , F1 + 2 , and TAT and CD41/62-positive platelets from baseline after transseptal puncture and before ablation were similar ( P > 0.05 ) . However , the percentage changes in CD62-positive platelets from baseline were significantly higher in patients treated with RF ablation ( 82 + /- 20 % ) than with cryoablation ( 22 + /- 14 % , P = 0.02 ) , although their plasma levels of beta-TG , F1 + 2 , and TAT were not different ( P > 0.05 ) . CONCLUSIONS Significant platelet and coagulation activations were observed during PV ablation procedures , and heparin administration only prevented activation of coagulation but not platelets . Persistent platelets activation was observed during RF energy application , but not during cryoablation
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 .