Comparative Effectiveness of Cryoballoon Ablation and Laser Balloon Ablation in Atrial Fibrillation Treatment: A Meta-Analysis

Background: Cryoballoon ablation (CBA) and laser balloon ablation (LBA) are important techniques for treating atrial fibrillation (AF). However, the differences in their effectiveness remain unclear. This study aimed to systematically evaluate and compare the efficacy of CBA and LBA in AF treatment. Methods: A comprehensive search of major databases, including PubMed, Cochrane Library, Embase, and Web of Science, was conducted up to July 2024 to identify clinical studies comparing CBA and LBA for treating AF. Odds ratios (ORs) were calculated using a fixed-effect model. Study differences, quality, and potential publication bias were also assessed. Results: A total of 16 randomized controlled trials (RCTs) involving 4437 patients were included in the meta-analysis. The meta-analysis showed that compared to LBA, CBA was associated with a higher risk of phrenic nerve paralysis (PNP) (OR: 1.81, 95% confidence interval (CI): 1.23–2.67, p = 0.003, I2 = 0.0%). However, CBA demonstrated a higher success rate of pulmonary vein isolation (PVI) (OR: 2.14, 95% CI: 1.18–3.88, p = 0.013, I2 = 11.2%) and a shorter surgery duration standardized mean difference (SMD): –0.58, 95% CI: –0.88 to –0.29, p = 0.000, I2 = 75.3%). No significant differences were found between CBA and LBA regarding stroke, cardiac tamponade, hematoma, or 12-month AF recurrence rates. Conclusion: Compared to LBA, CBA offers a higher success rate of PVI and shorter surgery durations but with an increased risk of PNP. The INPLASY Registration: INPLASY202480069, https://inplasy.com/inplasy-2024-8-0069/, last accessed on August 14, 2024.