{
  "abstract": "Introduction: Pulmonary vein isolation (PVI) alone achieves modest arrhythmia freedom in persistent atrial fibrillation (PeAF). Cryoballoon ablation (CBA) offers a single‐shot alternative to radiofrequency ablation (RFA) that streamlines procedural workflow. We aimed to quantify the clinical efficacy, procedural efficiency, and safety of CBA versus RFA through a meta‐analysis of randomized controlled trials (RCTs).\n\nMethods and Results: Systematic review of PubMed, Embase, and Scopus identified 5 RCTs enrolling 1,091 patients (515 CBA, 576 RFA). The primary endpoint was 12‐month freedom from any atrial arrhythmia, with isolated AF, and atrial tachycardia/flutter evaluated as secondary endpoints. Random‐effects models generated relative risks (RRs) and mean differences (MDs) with 95% confidence intervals (CI). Time‐to‐event data were pooled using a generic inverse‐variance approach to derive hazard ratios (HR). CBA and RFA demonstrated equivalent freedom from any arrhythmia (RR 0.97, 95% CI 0.81–1.15; p = 0.71). Time‐to‐event analysis corroborated a comparable recurrence hazard (HR 0.91, 95% CI 0.67–1.24; p = 0.56; I 2 = 0%). Repeat ablation rates were identical (RR 0.93; p = 0.50). CBA significantly reduced procedural time (MD −45.37 min; p < 0.0001), while major complications were comparable (1.5% vs. 2.7%; p = 0.18). Trial sequential analysis indicated that further randomization is unlikely to demonstrate superiority.\n\nConclusion: In PeAF, CBA and RFA achieve equivalent 12‐month arrhythmia‐free survival and comparable repeat‐ablation rates, while CBA confers a highly significant reduction in procedural time. However, reliance on 12‐month follow‐up and heterogeneous rhythm surveillance protocols may limit assessments of true long‐term durability.",
  "abstract_shown": true,
  "affiliations": [
    "Faculty of Medicine Imperial College London, England London UK",
    "London Northwest Healthcare NHS Trust, England London UK",
    "Department of Internal Medicine University of Pennsylvania Philadelphia Pennsylvania USA",
    "Chelsea and Westminster Hospital NHS Foundation Trust, England London UK",
    "National Heart and Lung Institute Imperial College London, England London UK",
    "Department of Cardiology Imperial College Healthcare NHS Trust, England London UK"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Harroop Bola",
      "orcid": "0000-0002-5197-9728"
    },
    {
      "affs": [
        0
      ],
      "name": "Aksaan Arif",
      "orcid": "0009-0003-5901-8694"
    },
    {
      "affs": [
        0
      ],
      "name": "Joshua J. Hon",
      "orcid": "0009-0004-1073-5825"
    },
    {
      "affs": [
        0
      ],
      "name": "Gayathri Giritharan"
    },
    {
      "affs": [
        0
      ],
      "name": "Prachur Khandelwal"
    },
    {
      "affs": [
        1
      ],
      "name": "Rodrick Avakian"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Amar Rai"
    },
    {
      "affs": [
        1
      ],
      "name": "Kiran Haresh Kumar Patel"
    },
    {
      "affs": [
        0,
        3,
        4,
        5
      ],
      "name": "Fu Siong Ng"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7eh4b5yh3jydb.bib",
  "cited_by": 0,
  "doi": "10.1111/pace.70350",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13739753/",
  "id": "7eh4b5yh3jydb",
  "issns": [
    "0147-8389",
    "1540-8159"
  ],
  "landing_url": "https://doi.org/10.1111/pace.70350",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Electrophysiology"
    ],
    [
      "openalex",
      "2705|Atrial Fibrillation Management and Outcomes"
    ]
  ],
  "openalex": "W7167202987",
  "pdf_url": null,
  "pmcid": "PMC13739753",
  "pmid": "42397058",
  "published": "2026-07-03",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7eh4b5yh3jydb.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T12:21:09Z",
      "native_id": "PMC13739753",
      "source": "pmc",
      "url": "https://doi.org/10.1111/pace.70350"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Atrial Fibrillation Management and Outcomes",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Cryoballoon Versus Radiofrequency Ablation for Persistent Atrial Fibrillation: Meta‐Analysis of Randomized Trials",
  "title_text": "Cryoballoon Versus Radiofrequency Ablation for Persistent Atrial Fibrillation: Meta‐Analysis of Randomized Trials",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T12:21:09Z",
  "url": "https://research.draconitic.com/paper/7eh4b5yh3jydb",
  "venue": "Pacing and Clinical Electrophysiology",
  "versions": []
}