Conclusion In patients with paroxysmal atrial fibrillation  , cryoballoon and radiofrequency ablation produce similar results in terms of freedom from recurrent atrial fibrillation or atrial tachyarrhythmias but with a different safety profile , being cryoballoon ablation less associated with cardiac complications but more likely to cause phrenic nerve palsy
Aims To perform an up date d meta- analysis to assess efficacy , safety and technical performance of pulmonary vein isolation using cryoballoon or radiofrequency catheter ablation in patients with paroxysmal or persistent atrial fibrillation .
Is the time between first diagnosis of paroxysmal atrial fibrillation and cryoballoon ablation a predictor of efficacy?
Aims Cryoablation is an indicated therapy for the treatment of recurrent atrial fibrillation through pulmonary vein isolation ; however , the optimal time between first diagnosis of atrial fibrillation and cryoablation is still unknown . We aim ed to assess the clinical efficacy and safety of early versus later treatment of patients with paroxysmal atrial fibrillation by cryoablation .  Methods Five hundred and ten patients underwent atrial fibrillation cryoablation and were prospect ively followed for at least 6 months in 43 Italian cardiology centers . The population was divided into two groups according to the time since the first diagnosis of atrial fibrillation until the index cryoablation procedure . An early-treatment group had an elapsed time of 15 months or less from atrial fibrillation diagnosis until cryoablation , and the late-treatment group had an elapsed time of greater than 15 months . During the evaluation , clinical efficacy was defined as atrial fibrillation recurrence outside a l and mark 90-day blanking period , and safety was defined as the reporting of all procedure-related complications . Results In the total cohort , cryoablation was performed after a median of 36 months from the point of the patient diagnosis with drug refractory symptomatic recurrent atrial fibrillation . The early-treatment group was composed of 130 ( 25 % ) patients , whereas the late-treatment group had 380 ( 75 % ) patients . Both cohorts had similar baseline clinical characteristics . Of 510 patients , 22 had a complication related to the procedure with no difference between the two groups . Multivariable analysis showed that the risk of atrial fibrillation recurrence was significantly higher in the late-treatment group ( hazard ratio : 1.77 ; 95 % confidence interval 1.00 - 3.13 ) Conclusion In our multicenter observational examination , cryoablation was well tolerated and effective in the treatment of patients with drug refractory symptomatic paroxysmal atrial fibrillation . Reducing the time between diagnosis and ablation brought about a treatment that had a lower risk of atrial fibrillation recurrence with no change in safety . ( Italian Clinical Service Project : NCT01007474 )
Conclusion In patients with paroxysmal atrial fibrillation  , cryoballoon and radiofrequency ablation produce similar results in terms of freedom from recurrent atrial fibrillation or atrial tachyarrhythmias but with a different safety profile , being cryoballoon ablation less associated with cardiac complications but more likely to cause phrenic nerve palsy
Aims To perform an up date d meta- analysis to assess efficacy , safety and technical performance of pulmonary vein isolation using cryoballoon or radiofrequency catheter ablation in patients with paroxysmal or persistent atrial fibrillation .