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Efficacy and safety of cryoballoon ablation in the elderly: A systematic review and meta‑analysis of clinical trials

  • Authors:
    • Qian Zhang
    • Lei Yu
    • Jing Geng
    • Hong-Bo Tian
    • Xuexun Li
  • View Affiliations / Copyright

    Affiliations: Department of Endocrinology, Jinan Third People's Hospital, Ji'nan, Shandong 250021, P.R. China, Department of Cardiology, Jinan Third People's Hospital, Ji'nan, Shandong 250021, P.R. China, Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji'nan, Shandong 250021, P.R. China
    Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 183
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    Published online on: July 29, 2025
       https://doi.org/10.3892/etm.2025.12933
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Abstract

Cryoballoon ablation has comparable efficacy with catheter ablation in atrial fibrillation (AF) treatment. However, there has been no systematic review or meta‑analysis on this subject despite some studies on cryoballoon ablation in elderly patients with AF. The PubMed, Embase, Cochrane Library and Web of Science databases were comprehensively searched up to February 2023. The present study selected trials that compared the efficacy and safety of cryoballoon ablation in the elderly with the young that lasted for ≥12 months. The Preferred Reporting Items for Systematic Reviews and Meta‑Analyses guidelines were used to conduct the present review. For quality assessment of included studies, the Newcastle‑Ottawa scale was used. Two reviewers screened all articles independently according to the inclusion criteria. The main outcomes were procedural time, fluoroscopy time, success rate and transient phrenic nerve palsy (tPNP). A total of six articles were ultimately included. Data regarding procedural time, fluoroscopy time and success rate were available for five trials. The tPNP complication rate was reported in all trials. The differences in procedural time (mean difference, 0.29; 95% CI, ‑4.93 to 5.50; P=0.91), fluoroscopy time (mean difference, ‑0.59; 95% CI, ‑2.07 to 0.89; P=0.43), success rate (odds ratio, 0.981; 95% CI, 0.72 to 1.34; P=0.903) and tPNP rate (mean difference, 0.955; 95% CI, 0.452 to 2.020; P=0.904) between the elderly and young groups were all not significant. It was concluded that cryoballoon ablation was as safe and effective in elderly patients with AF as in young patients.
View Figures

Figure 1

Flow diagram of study selection for
meta-analysis.

Figure 2

Pooled data for the analysis of
efficacy and safety. (A) Procedural time. (B) Fluoroscopy time.
WMD, weighted mean difference.

Figure 3

Freeze times in PVs. (A) LSPV, (B)
LIPV, (C) RSPV and (D) RIPV. PVs, pulmonary veins; LSPV, left
superior PV; LIPV, left inferior PV; RSPV, right superior PV; RIPV,
right inferior PV; WMD, weighted mean difference.

Figure 4

Minimum temperature in PVs. (A) LSPV,
(B) LIPV, (C) RSPV and (D) RIPV. PVs, pulmonary veins; LSPV, left
superior PV; LIPV, left inferior PV; RSPV, right superior PV; RIPV,
right inferior PV; WMD, weighted mean difference.

Figure 5

Pulmonary vein freeze duration. (A)
LSPV, (B) LIPV, (C) RSPV and (D) RIPV. LSPV, left superior
pulmonary vein; LIPV, left inferior pulmonary vein; RSPV, right
superior pulmonary vein; RIPV, right inferior pulmonary vein.

Figure 6

Pulmonary vein reconduction in the
redo procedure. OR, odds ratio.

Figure 7

Funnel plot. Comparison of procedure
time between the elderly and young patients. WMD, weighted mean
difference.

Figure 8

Sensitive analysis. Comparison of
fluoroscopy time between the elderly and young patients.
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Copy and paste a formatted citation
Spandidos Publications style
Zhang Q, Yu L, Geng J, Tian H and Li X: Efficacy and safety of cryoballoon ablation in the elderly: A systematic review and meta‑analysis of clinical trials. Exp Ther Med 30: 183, 2025.
APA
Zhang, Q., Yu, L., Geng, J., Tian, H., & Li, X. (2025). Efficacy and safety of cryoballoon ablation in the elderly: A systematic review and meta‑analysis of clinical trials. Experimental and Therapeutic Medicine, 30, 183. https://doi.org/10.3892/etm.2025.12933
MLA
Zhang, Q., Yu, L., Geng, J., Tian, H., Li, X."Efficacy and safety of cryoballoon ablation in the elderly: A systematic review and meta‑analysis of clinical trials". Experimental and Therapeutic Medicine 30.4 (2025): 183.
Chicago
Zhang, Q., Yu, L., Geng, J., Tian, H., Li, X."Efficacy and safety of cryoballoon ablation in the elderly: A systematic review and meta‑analysis of clinical trials". Experimental and Therapeutic Medicine 30, no. 4 (2025): 183. https://doi.org/10.3892/etm.2025.12933
Copy and paste a formatted citation
x
Spandidos Publications style
Zhang Q, Yu L, Geng J, Tian H and Li X: Efficacy and safety of cryoballoon ablation in the elderly: A systematic review and meta‑analysis of clinical trials. Exp Ther Med 30: 183, 2025.
APA
Zhang, Q., Yu, L., Geng, J., Tian, H., & Li, X. (2025). Efficacy and safety of cryoballoon ablation in the elderly: A systematic review and meta‑analysis of clinical trials. Experimental and Therapeutic Medicine, 30, 183. https://doi.org/10.3892/etm.2025.12933
MLA
Zhang, Q., Yu, L., Geng, J., Tian, H., Li, X."Efficacy and safety of cryoballoon ablation in the elderly: A systematic review and meta‑analysis of clinical trials". Experimental and Therapeutic Medicine 30.4 (2025): 183.
Chicago
Zhang, Q., Yu, L., Geng, J., Tian, H., Li, X."Efficacy and safety of cryoballoon ablation in the elderly: A systematic review and meta‑analysis of clinical trials". Experimental and Therapeutic Medicine 30, no. 4 (2025): 183. https://doi.org/10.3892/etm.2025.12933
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