title: Cryoballoon versus RF ablation in paroxysmal atrial fibrillation: results from the German Ablation Registry.
abstract: BACKGROUND
  Catheter ablation is used extensively with curative intention in atrial fibrillation. Radiofrequency ablation has long been a standard of care, while cryoballoon technology has emerged as a feasible approach with promising results. Prospective multicenter registry data referring to both ablation technologies in AF ablation therapy are lacking.
  
  
  METHODS
  Between January 2007 and August 2011, a total of 3,775 consecutive patients with symptomatic paroxysmal AF who underwent PV ablation in their respective centers were enrolled. The cohort was divided into 2 groups according to the ablation energy source used: cryoballoon ablation (group 1, n = 905 [24.0%], median age 63 years, 64.3% men) and RF ablation (group 2, n = 2870 [76.0%], median age 63 years, 62.7% men). Comorbidities and baseline clinical characteristics were similar in both groups.
  
  
  RESULTS
  Acute success rate was similar in both groups (97.5% in cryo vs 97.6% in RF; P = 0.81). Procedure times were similar, ablation and fluoroscopy times were higher in cryoballoon when compared to RF ablation. Overall complication rate was similar in cryo- (4.6%) and RF-ablation (4.6%; P = 1.0). Phrenic nerve palsy was more often in cryo versus RF ablation (2.1% in cryo vs 0.0% in RF; P < 0.001). Other complications were more common in RF compared to cryoablation (4.6% in RF vs 2.7% in cryo; P < 0.05).
  
  
  CONCLUSIONS
  RF ablation is the most widespread ablation method in Germany, but use of cryoballoon increased significantly. Procedure times were similar, but ablation and fluoroscopy times were longer in cryoballoon ablation. No significant differences were found in terms of acute success and overall complication rate.
authors.affiliation: Department of Cardiology, Klinikum Bogenhausen, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Schmidt
authors.forename: Uwe
authors.initials: U
authors.lastname: Dorwarth
authors.forename: Dietrich
authors.initials: D
authors.lastname: Andresen
authors.forename: Johannes
authors.initials: J
authors.lastname: Brachmann
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Malte
authors.initials: M
authors.lastname: Kuniss
authors.forename: Thorsten
authors.initials: T
authors.lastname: Lewalter
authors.forename: Stefan
authors.initials: S
authors.lastname: Spitzer
authors.forename: Stephan
authors.initials: S
authors.lastname: Willems
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Claus
authors.initials: C
authors.lastname: Jünger
authors.forename: Ellen
authors.initials: E
authors.lastname: Hoffmann
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries
keywords: atrial fibrillation; catheter ablation; cryoablation; cryoballoon; registry