Both cryoballoon ablation (CBA) and hot balloon ablation (HBA) are effective treatment options for atrial fibrillation (AF), however, patients treated with HBA are more likely to receive touch-up ablation, with a longer procedure time. This was the main concluding finding of a recent systematic review and meta-analysis published in the February Issue of the European Heart Journal.
According to the authors of the analysis, despite catheter ablation developing as “the most effective therapeutic response” in treating AF, HBA and CBA are rapidly emerging, however, differences in effectiveness, clinical outcomes, safety, and efficacy are still unknown. X Peng (Beijing Chaoyang Hospital affiliated to Capital Medical University, Beijing, China) et al set to compare differences in prognosis and characteristics between HBA and CBA.
The analysis was conducted in a total of six databases, namely PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrial.gov, and medRxiv, using specific search strategies, up to 1 June 2021, the authors relay. The average difference, odds ratios (ORs), and 95% confidence interval (95% CI) to evaluate the clinical outcomes of HBA and CBA were then calculated by the research team. Additionally, the authors note heterogeneity and risk of bias were assessed with predefined criteria.
A total of seven studies were included within the final meta-analysis, eluding that more patients in the HBA group required touch-up ablation in comparison to patients who received CBA (OR 2.76, 95% CI, 2.02, 3.77, p=0.000). The HBA group demonstrated more residual conduction and had a longer procedure duration than the CBA group (95%CI 4.39, p = 0.005). The occurrence of AF was seen more in the CBA group (OR 0.75, 95% CI, 0.44, 1.27, p=0.0281), this group also accepted more antiarrhythmic drug therapy (OR 0.70, 95% CI, 0.45, 1.09, p=0.114), despite insignificant results.
Looking forward, the authors highlight that further studies of multicentre, randomised clinical trials are required to fully understand the long-term safety of both HBA and CBA.