FIRE AND ICE
Fire and Ice Trial: Cryoballoon versus Radiofrequency Ablation for Paroxysmal Atrial Fibrillation
Patient / Population Intervention / Exposure Comparison Outcome
In 762 patients with drug-refractory paroxysmal atrial fibrillation, cryoballoon ablation was non-inferior for clinical treatment failure compared with radiofrequency ablation.
N
762
Design
Multicentre open-label non-inferiority RCT
Endpoint
First clinical failure (recurrent AF, flutter/tachycardia, AAD use, or repeat ablation) after 90-day blanking
Relevance
3
Result34.6% vs 35.9% at 1 year (HR 0.96, 95% CI 0.76-1.22; P<0.001 for non-inferiority). Cryoballoon non-inferior to radiofrequency; safety similar.
Kuck KH, et al. N Engl J Med. 2016;374(23):2235-2245. 10.1056/NEJMoa1602014
Discussion & critique
Restricted to paroxysmal AF and used first-generation as well as newer cryoballoons, limiting generalisability. Validated cryoballoon ablation as an efficient, reproducible alternative to point-by-point radiofrequency.