Atrial Fibrillation

PFA or Cryoballoon for Paroxysmal AFib?

Expanding the potential patient population for pulsed field ablation, results from the SINGLE SHOT CHAMPION study suggest PFA might be just as good as cryoballoon ablation for patients with paroxysmal AFib.

  • Paroxysmal atrial fibrillation is a type of AFib that causes short, intermittent episodes of irregular and rapid heartbeats originating in the atria.
  • Cryoballoon ablation is typically used to treat PAF and involves using a balloon catheter to freeze heart tissue and isolate the pulmonary veins that can cause irregular heartbeats.
  • PFA has shown advantages in procedure time and safety, but its effectiveness is unproven compared to cryoballoon ablation.

In one of the first PFA versus cryoballoon head-to-heads, researchers randomized 210 patients with symptomatic paroxysmal AFib to undergo PFA with Boston Scientific’s Farapulse or cryoablation.

  • Atrial tachyarrhythmia recurred in 37.1% of the PFA group compared to 50.7% of the cryoballoon group between day 91 and day 365 after the procedure.
  • Both procedures were safe and had similar complications rates (1% for PFA vs. 2% for cryoballoon).
  • Delivering on its efficiency reputation, PFA procedures were shorter on average than cryoablation (55 vs. 73 minutes).

Although those stats seem to favor PFA, it’s important to note that the trial was strictly designed to determine non-inferiority, so these results can only suggest PFA is as good as cryoballoon ablation for paroxysmal AFib.

  • Future studies with larger enrollment, a longer follow-up, and measured AFib burden before and after ablation would be needed to truly say if one is better than the other.

The Takeaway

While this study has several limitations, it adds to the body of evidence for considering PFA as a first-line treatment for AFib rather than as an unproven newcomer. We’ll still have to wait for future studies to see whether PFA’s outcomes will match its safety and efficiency benefits.

Get twice-weekly insights on the biggest stories shaping cardiology.

You might also like

Cardiology August 28, 2025

Cardiologists, Practice What You Preach! August 28, 2025

Cardiologists might be struggling with the same lifestyle challenges they counsel patients about, as a national survey of ACC members revealed significant gaps between what physicians’ recommend and how they act. The ACC CardioSurve study surveyed 166 U.S. cardiologists about their training in lifestyle medicine and clinical recommendations across all six lifestyle pillars, revealing some […]

Obesity Care August 25, 2025

GLP-1s Work, But Not for Free August 25, 2025

Real-world semaglutide (Wegovy) patients might be experiencing a healthcare cost paradox, after a recent analysis in JAMA showed that GLP-1s successfully reduce weight and improve cardiovascular risk factors, but lead to increased patient healthcare expenditures in the short term. The real-world analysis examined 23.5k adults prescribed semaglutide between January 2018 and January 2025 across two […]

Electrophysiology August 21, 2025

Conduction-System Pacing Succeeds at Treating AV Block August 21, 2025

Conduction-system pacing could be poised to reshape standard care for atrioventricular (AV) block patients after the randomized CSPACE trial demonstrated its significant benefits over traditional right ventricular septal pacing. Taking a closer look at CSP’s potential, the CSPACE trial enrolled 202 patients with AV block at two Australian hospitals, randomizing them to conduction-system pacing or […]

You might also like..

Select All

You're signed up!

It's great to have you as a reader. Check your inbox for a welcome email.

-- The Cardiac Wire Team

You're all set!