Comparative Effectiveness and Safety of Cryoablation Versus Radiofrequency Ablation Treatments for Persistent Atrial Fibrillation.

The purpose of this study was to compare the effectiveness and safety of 2 strategies for catheter treatment of patients with persistent atrial fibrillation in the long-term period, using cardiac implantable loop recorders. The research is a prospective, randomized, controlled study designed to compare the results of modern catheter technologies in patients with persistent atrial fibrillation. The study included 127 patients with persistent atrial fibrillation in the last 6 months before inclusion in the study, for whom at least 2 antiarrhythmic drugs of class I to III were not effective. By random distribution, 50 patients were included in group 1; they underwent cryoballoon ablation, using a cryoballoon of the second generation. Group 2 also included 50 patients who underwent radiofrequency ablation, where a catheter was used to control the contact force. Cardiac implantable loop electrocardiogram recorders were implanted in all patients after surgery. The average duration of follow-up was 36 months. The primary end point of efficacy occurred in 15 patients in the group with cryoballoon ablation and 14 patients in the group with radiofrequency ablation. In conclusion, the primary effectiveness was relatively the same in the groups; yet, in the long-term period, the superiority of radiofrequency ablation using catheters with pressure control was noted, but the difference in results was statistically insignificant (p <0.672) and there was no significant difference between the 2 methods in terms of overall safety.