Frontiers in cardiovascular medicine · 2026
Quality of life after cryoballoon vs. radiofrequency ablation in atrial fibrillation: a subanalysis of the FREEZE cohort study.
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Pongratz J, Kuniss M, Wu L-Q, Tebbenjohanns J, Nölker G, Dorwarth U, Kuck K-H, Senges J, Hoffmann E, Straube F, FREEZE Cohort Study Investigators
Аннотация
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.
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.