This study aims to compare the fluoroscopy use between cryoballoon ablation (CBA) and radiofrequency ablation (RFA) for the treatment of paroxysmal atrial fibrillation (PAF) .

The study was designed as a single-centered prospective cohort protocol. 43 continuous patients (RFA, 21, CBA, 22) were alternatively enrolled. The fluoroscopy equipment and parameter setting was same for the two groups. Detailed information about the fluoroscopy use including time and dose usage was recorded for every major step. Procedure time, acute pulmonary vein isolation (PVI) rates and complications were also recorded.

No significant differences on baseline characteristics were observed between the two groups. The fluoroscopy time for CBA group was longer than RFA group [RFA (10.0±4.5) min vs. CBA (14.9±3.4) min, P<0.001] . The fluoroscopy dose was substantially higher in CBA group compared with RFA group for total procedure [RFA, (59.6±34.9) mGy vs.CBA, (189.2±85.4) mGy, P<0.001] , and more prominent in left atrial dwell period [CBA, (179.2±23.1) mGy vs. RFA, (41.6±23.1) mGy, P<0.001] . The differences of fluoroscopy dose among 4 pulmonary veins (PVs) in CBA group did not achieve statistical significance left superior pulmonary vein (LSPV) 39.4±22.4 mGy, left inferior pulmonary vein (LIPV) 32.9±24.9 mGy, right inferior pulmonary vein (RIPV) 19.8±12.5 mGy, right superior pulmonary vein (RSPV) 29.6±17.0 mGy; P=0.155) . The total procedure time [RFA, (96.0±20.8) min, vs. CBA, (100.4±15.7) min, P=0.451] , acute PVI successful rate (100% in both groups) and acute phase complication rate (RFA, 0%; CBA, 4.5%, P=1.000) were similar between RFA and CBA group.

In this study, both the fluoroscopy time and fluoroscopy dose were higher in CBA group compared with that in RFA group, especially in left atrium dwell period. The fluoroscopy dose might represent the actual fluoroscopy exposure better than fluoroscopy time during procedure.

Atrial fibrillation; Radiofrequency ablation; Cryoballoon ablation