Background – Cryoballoon pulmonary vein isolation (PVI) is a well-established single-shot procedure used to treat atrial fibrillation (AF). 

Purpose – We conducted a comparative analysis to evaluate the efficiency and outcome of two commercially available cryoballoon ablation systems (CBS) to treat AF 

Methods – In this prospective study, we enrolled 121 consecutive AF patients who were treated with either the compliant CBS (POLARx™, Boston Scientific) or the non-compliant CBS (Arctic Front Advance Pro™, Medtronic). 

Results – Analysis of procedural characteristics revealed that the group using the compliant CBS experienced a significantly longer procedure duration (p=0.007) and concomitant fluoroscopy time (p=0.008). However, there was no significant difference in the time to isolation and acute pulmonary vein isolation between the two groups. 

The mean follow-up period was 310.8±189.7 days within a 90-day blanking period. Of the patients treated with the non-compliant CBS, 68% showed freedom from atrial arrhythmia recurrence, while 65% of those treated with the compliant CBS exhibited the same outcome (p=0.724). Kaplan-Meier estimation demonstrated no significant difference in recurrence rates between the two groups (LogRank p=0.768). 

Conclusion – The novel compliant CBS resulted in a longer procedure duration and increased fluoroscopy time but no difference in efficiency of acute pulmonary vein isolation. Freedom from atrial arrhythmia recurrence, after an average follow-up period of ten months, did not differ between the two CBS groups.