Radiofrequency Versus Cryoballoon 180-Day Mortality Risk After Atrial Fibrillation Ablation: An 8-Year Analysis.

Introduction: Catheter ablation (CA) is a preferred treatment for atrial fibrillation (AF), often outperforming antiarrhythmic medications in maintaining sinus rhythm and managing symptoms. One of the most important features of any treatment method, alongside its effectiveness, is its safety.

Methods: This study evaluates 180-day all-cause mortality rates post-ablation using data from the National Health Fund in Poland (NHF-P), encompassing over 99% of AF CAs and 100% of deaths in Poland from 2012 to 2019.

Results: Our analysis, which included 31,214 ablations on 26,767 patients (34.8% female), compared cryoballoon and radiofrequency (RF) ablation techniques and assessed mortality rates and risk factors. The study revealed a 180-day mortality rate of 0.56%, with the highest rate observed in patients over 80 years old (2.67%) and the lowest in those aged 18-34 years (0.29%). Mortality did not significantly differ between cryoballoon (0.48%) and RF ablation (0.65%; p = 0.072). The risk of mortality did not differ between patients undergoing a first-time ablation and those having subsequent procedures (p = 0.90, OR 0.92). Significant risk factors for increased mortality included male sex, kidney disease, heart failure, diabetes, prior myocardial infarction, and a history of malignancy.

Conclusion: The 180-day mortality rate after AF ablation procedure reached 0.56%, with no significant difference between cryoballoon and RF ablation. Further research, including matched control groups and extended follow-up periods, is essential to better understand the benefits and risks of CA for AF, particularly in the oldest patient groups.