The Hot and the Cold: Radiofrequency Versus Cryoballoon Ablation for Atrial Fibrillation
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Catheter ablation is superior to antiarrhythmic drugs in maintaining sinus rhythm for patients with atrial fibrillation (AF). Pulmonary vein (PV) isolation is the cornerstone of any AF ablation procedure. Conventionally, this is achieved by performing point by point lesions using radiofrequency (RF) energy. However, this is technically challenging, time consuming and is associated with a number of complications. Long-term durability of PV isolation is also a concern. To address these issues, ‘one-shot’ energy delivery systems and alternative energy sources have been developed. The cryoballoon system has emerged as the most commonly used alternative to point by point RF technology. In this paper, we compare the technology, biophysics and clinical data of cryoballoon to conventional RF ablation for AF. The safety and efficacy of cryoballoon compared to RF ablation is critically reviewed. We conclude by looking at future applications of this technology.
KeywordsCryoballoon RF Catheter ablation Atrial fibrillation
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Conflict of Interest
Richard Ang, Giulia Domenichini, and Ross J. Hunter declare that they have no conflict of interest.
Malcolm C. Finlay reports personal fees from and is a shareholder of Epicardio Ltd, personal fees and non-financial support from Biotronik UK Ltd, and non-financial support from Medtronic UK.
Richard J. Schilling reports grants from Medtronic and personal fees, speaker fees and travel expenses from Medtronic.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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