Quality of life after cryoballoon vs. radiofrequency ablation in atrial fibrillation: a subanalysis of the FREEZE cohort study
Year: 2026
Type: article
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.
Authors: J. Pongratz, M. Kuniss, L.-Q. Wu, J. Tebbenjohanns, G. Nölker, U. Dorwarth, K.-H. Kuck, J. Senges, E. Hoffmann, F. Straube, Garcia Alberola A., C. Stellbrink, D. Thomas, H.A. Katus, D. Thomas, D. Thomas, K.R.J. Chun, G. Groschup, J.-H. Gerds-Li, J.W. Schrickel, A. Metzner, R.R. Tilz, A. Stanley, I.W.P. Obel, R.R. Gopal, L. Lickfett, A. Lubinski, B. Schumacher, J.J. Souza, C. Steinwender, H. U. Hink, A. Franke, T. Ouarrak, J. Brachmann
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7221083912