Arrhythmias & electrophysiologyRandomised controlled trial
Cryoballoon ablation vs. antiarrhythmic drug therapy as initial treatment for persistent atrial fibrillation: the multicentre randomized CEPAF trial
- Randomised controlled trial
- multicentre
- prospective
- open-label
Authors' conclusion
In selected treatment-naive patients with PersAF, first-line CBA reduced atrial tachyarrhythmia recurrence and improved disease-specific quality of life compared with AAD therapy.
Study context
- Population
- Symptomatic, treatment-naive patients with persistent AF
- Participants
- 320 participants
- Comparison
- Cryoballoon ablation (CBA) vs AAD
- CBAn = 160
- AADn = 160reference
- Primary endpoint
- First documented atrial tachyarrhythmia recurrence lasting ≥30 s
- Follow-up
- Days 91-365
Primary result
As reported in the abstract
Absolute difference
−25.6 percentage points
95% CI −35.4 to −15.8
P < 0.001
Events by treatment group
CBA vs AAD
absolute difference −25.6 percentage points (95% CI −35.4 to −15.8); P < 0.001
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Recurrence, time-to-event (supportive) | 2.29 (1.48–3.56) | log-rank P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Overall recurrence · days 1-365
P < 0.001
Early recurrence · days 1-90
P < 0.001
Improvement in AFEQT score
P < 0.001
SF-12 component scores
- Did not differ significantly
Safety
Adverse events
- Infrequent in both cohorts
Original publication
Cryoballoon ablation vs. antiarrhythmic drug therapy as initial treatment for persistent atrial fibrillation: the multicentre randomized CEPAF trial. Europace. Published 1 September 2026. doi:10.1093/europace/euag230
Summarised from the published abstract; every number is checked against it