Arrhythmias & electrophysiology
Cryoballoon pulmonary vein isolation: Double stack vs standard ablation
Corrected 23 Oct 2026: Measure wording clarified; no values changed.
Authors' conclusion
In a mixed cohort of patients with paroxysmal and persistent AF, cryoballoon ablation using the double stack technique is associated with lower rates of AF recurrence, aggregate healthcare utilisation, and lower rates of repeat ablation.
Study context
- Population
- Patients referred for cryoballoon-based pulmonary vein isolation (PVI) (paroxysmal and persistent AF)
- Participants
- 226 consecutive patients
- Exposure
- Double stack cryoballoon PVI vs standard cryoballoon ablation
- Outcome
- Atrial tachyarrhythmia recurrence
- Follow-up
- Up to 1 year
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Freedom from recurrent AF/atrial tachycardia/atrial flutter
Hazard ratio
0.41
95% CI 0.24–0.71, event not clearly stated
P = 0.008
By group
Double stack vs Standard
HR 0.41 (95% CI 0.24–0.71), event not clearly stated; P = 0.008
Observational data: associations, not effects.
Secondary outcomes
Repeat ablation · up to 1 year
- Significantly fewer patients treated with double stack underwent repeat ablation (1.3% vs 13.5%)
- P = 0.002
Cardioversion · up to 1 year
- No difference between groups (12.8% vs 20.3%)
- P = 0.20
ED visit · up to 1 year
- No difference between groups (9.0% vs 15.5%)
- P = 0.22
All-cause hospitalisation · up to 1 year
- No difference between groups (1.3% vs 2.7%)
- P = 0.66
Safety
Periprocedural complications
- Similar between groups (5.2% vs 3.4%)
- P = 0.50
Original publication
Cryoballoon pulmonary vein isolation: Double stack vs standard ablation. Heart Rhythm. Published 28 January 2025. doi:10.
Summarised from the published abstract; every number is checked against it