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Peer-reviewedCC BYFrontiers in cardiovascular medicine

Quality of life after cryoballoon vs. radiofrequency ablation in atrial fibrillation: a subanalysis of the FREEZE cohort study

  • J. Pongratz1
  • M. Kuniss2
  • L.-Q. Wu3
  • J. Tebbenjohanns4
  • G. Nölker5
  • U. Dorwarth1
  • K.-H. Kuck6
  • J. Senges7
  • E. Hoffmann1
  • F. Straube1
7 affiliations
  1. 1Klinik für Kardiologie und Internistische Intensivmedizin, München Klinik Bogenhausen , ,
  2. 2Abteilung für Kardiologie, Kerckhoff Klinik GmbH , ,
  3. 3Department of Cardiology, Shanghai Rui Jin Hospital , ,
  4. 4Med. Klinik I, Helios Klinikum Hildesheim GmbH , ,
  5. 5Innere Klinik II/Kardiologie, Christliches Klinikum Unna-Mitte , ,
  6. 6Klinik für Rhythmologie, Universitätsklinikum Schleswig-Holstein , ,
  7. 7Stiftung Institut für Herzinfarktforschung , ,
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Abstract

Background: Catheter ablation for symptomatic atrial fibrillation (AF) is an established treatment, with cryoballoon (CBA) and radiofrequency ablation (RFA) showing similar success rates. However, comparative data on health-related quality of life (HRQoL) outcomes between these methods are limited. This study compares HRQoL changes following CBA vs. RFA in symptomatic AF patients.

Methods: This sub-analysis of the FREEZE Cohort Study (NCT01360008) compared HRQoL outcomes between CBA (group A) and RFA (group B) using the EQ-5D-3L questionnaire and EHRA symptom scores at baseline and follow-up. Changes in mobility, self-care, usual activities, pain/discomfort, anxiety/depression, EQ-VAS, and general physical condition (GPC) were assessed.

Results: Between 2011 and 2016, 4,189 patients were included, with 2,110 (50.4%) completing all HRQoL questionnaires. The mean age was 61.8 ± 10.4 years, with 39.2% female patients. Group A had a higher proportion of patients with paroxysmal AF (72.8% vs. 65.4%, p < 0.01). Overall complication rates were similar (7.6% vs. 10.1%, p = 0.07). The median follow-up was 434 (375, 517) days. Atrial arrhythmia recurrence was more frequent in group B (45.0% vs. 56.9%, p < 0.0001), as were repeat ablations (7.9% vs. 22.3%, p < 0.001) and rehospitalizations (26.0% vs. 46.7%, p < 0.0001). Both groups experienced significant improvements in HRQoL. After multivariable adjustment, group A remained associated with greater improvement in pain/discomfort (aOR 1.62, 95% CI 1.26–2.08), EQ-VAS (aOR 1.60, 95% CI 1.27–2.02), and the EuroQol 5D-Score (aOR 1.39, 95% CI 1.10–1.76).

Conclusion: Both CBA and RFA significantly improved HRQoL. However, CBA was associated with greater improvements in pain/discomfort, EQ-VAS, and the EuroQol 5D-Score, indicating potential differences in selected HRQoL outcomes between ablation modalities.

Clinical Trial Registration: NCT01360008.

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Cite

BibTeXRIS
BibTeX
@article{pongratz2026quality,
  title = {{Quality of life after cryoballoon vs. radiofrequency ablation in atrial fibrillation: a subanalysis of the FREEZE cohort study}},
  author = {J. Pongratz and M. Kuniss and L.-Q. Wu and J. Tebbenjohanns and G. Nölker and U. Dorwarth and K.-H. Kuck and J. Senges and E. Hoffmann and F. Straube},
  journal = {Frontiers in cardiovascular medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1877743},
  url = {https://europepmc.org/article/PMC/PMC13690627},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Quality of life after cryoballoon vs. radiofrequency ablation in atrial fibrillation: a subanalysis of the FREEZE cohort study
AU  - J. Pongratz
AU  - M. Kuniss
AU  - L.-Q. Wu
AU  - J. Tebbenjohanns
AU  - G. Nölker
AU  - U. Dorwarth
AU  - K.-H. Kuck
AU  - J. Senges
AU  - E. Hoffmann
AU  - F. Straube
PY  - 2026
DA  - 2026/10/09
JO  - Frontiers in cardiovascular medicine
DO  - 10.3389/fcvm.2026.1877743
UR  - https://europepmc.org/article/PMC/PMC13690627
AB  - Background: Catheter ablation for symptomatic atrial fibrillation (AF) is an established treatment, with cryoballoon (CBA) and radiofrequency ablation (RFA) showing similar success rates. However, comparative data on health-related quality of life (HRQoL) outcomes between these methods are limited. This study compares HRQoL changes following CBA vs. RFA in symptomatic AF patients.  Methods: This sub-analysis of the FREEZE Cohort Study (NCT01360008) compared HRQoL outcomes between CBA (group A) and RFA (group B) using the EQ-5D-3L questionnaire and EHRA symptom scores at baseline and follow-up. Changes in mobility, self-care, usual activities, pain/discomfort, anxiety/depression, EQ-VAS, and general physical condition (GPC) were assessed.  Results: Between 2011 and 2016, 4,189 patients were included, with 2,110 (50.4%) completing all HRQoL questionnaires. The mean age was 61.8 ± 10.4 years, with 39.2% female patients. Group A had a higher proportion of patients with paroxysmal AF (72.8% vs. 65.4%, p < 0.01). Overall complication rates were similar (7.6% vs. 10.1%, p = 0.07). The median follow-up was 434 (375, 517) days. Atrial arrhythmia recurrence was more frequent in group B (45.0% vs. 56.9%, p < 0.0001), as were repeat ablations (7.9% vs. 22.3%, p < 0.001) and rehospitalizations (26.0% vs. 46.7%, p < 0.0001). Both groups experienced significant improvements in HRQoL. After multivariable adjustment, group A remained associated with greater improvement in pain/discomfort (aOR 1.62, 95% CI 1.26–2.08), EQ-VAS (aOR 1.60, 95% CI 1.27–2.02), and the EuroQol 5D-Score (aOR 1.39, 95% CI 1.10–1.76).  Conclusion: Both CBA and RFA significantly improved HRQoL. However, CBA was associated with greater improvements in pain/discomfort, EQ-VAS, and the EuroQol 5D-Score, indicating potential differences in selected HRQoL outcomes between ablation modalities.  Clinical Trial Registration: NCT01360008.
SN  - 2297-055X
ER  -