Table 1 Open in new tab Comparison...

	Thermal energy	Non-thermal energy
Mechanism	Freezing	Heating	Electric current generation
Characteristics	Thermal cell damage	Thermal cell damage	Non-thermal cell damage
Tissue selectivity	Nonselective	Nonselective	Selective
Catheters footprint	Balloon	Balloon & Point-by-point	Different footprints
Time to ablation effect	Time-needed thermal effect	Time-needed thermal effect	Instant electroporation
Patient preparation	Deep sedation or GA	Deep sedation or GA	Deep sedation or GA
Fluoroscopy	Majority needed	Majority needed	Needed
3-D mapping integration	No	Yes	With or without
First pass PVI	> 98%	98%	~100%
Ablation time	++	++	+
Single-shot isolation	+	+	++
Ablation beyond PVs	No	Yes	Possible
Adjacent tissue damage*	Yes	Yes	No
Pericardial injury	Rare	+	No
Esophageal fistula	No	+	No
Phrenic nerve palsy	+ (usually transient)	Rare	No
Coronary artery injury	No	Possible	+ (spasm with pentaspline)
Hemolysis	No	No	Possible
Durability at 1 year	60–73%	70–90%	70–90%

	Thermal energy	Non-thermal energy
Mechanism	Freezing	Heating	Electric current generation
Characteristics	Thermal cell damage	Thermal cell damage	Non-thermal cell damage
Tissue selectivity	Nonselective	Nonselective	Selective
Catheters footprint	Balloon	Balloon & Point-by-point	Different footprints
Time to ablation effect	Time-needed thermal effect	Time-needed thermal effect	Instant electroporation
Patient preparation	Deep sedation or GA	Deep sedation or GA	Deep sedation or GA
Fluoroscopy	Majority needed	Majority needed	Needed
3-D mapping integration	No	Yes	With or without
First pass PVI	> 98%	98%	~100%
Ablation time	++	++	+
Single-shot isolation	+	+	++
Ablation beyond PVs	No	Yes	Possible
Adjacent tissue damage*	Yes	Yes	No
Pericardial injury	Rare	+	No
Esophageal fistula	No	+	No
Phrenic nerve palsy	+ (usually transient)	Rare	No
Coronary artery injury	No	Possible	+ (spasm with pentaspline)
Hemolysis	No	No	Possible
Durability at 1 year	60–73%	70–90%	70–90%

Table 1

Comparison between the current ablation modalities.

	Thermal energy		Non-thermal energy
	CBA	RFA	PFA
Mechanism	Freezing	Heating	Electric current generation
Characteristics	Thermal cell damage	Thermal cell damage	Non-thermal cell damage
Tissue selectivity	Nonselective	Nonselective	Selective
Catheters footprint	Balloon	Balloon & Point-by-point	Different footprints
Time to ablation effect	Time-needed thermal effect	Time-needed thermal effect	Instant electroporation
Patient preparation	Deep sedation or GA	Deep sedation or GA	Deep sedation or GA
Fluoroscopy	Majority needed	Majority needed	Needed
3-D mapping integration	No	Yes	With or without
First pass PVI	> 98%	98%	~100%
Ablation time	++	++	+
Single-shot isolation	+	+	++
Ablation beyond PVs	No	Yes	Possible
Adjacent tissue damage*	Yes	Yes	No
Pericardial injury	Rare	+	No
Esophageal fistula	No	+	No
Phrenic nerve palsy	+ (usually transient)	Rare	No
Coronary artery injury	No	Possible	+ (spasm with pentaspline)
Hemolysis	No	No	Possible
Durability at 1 year	60–73%	70–90%	70–90%

	Thermal energy		Non-thermal energy
	CBA	RFA	PFA
Mechanism	Freezing	Heating	Electric current generation
Characteristics	Thermal cell damage	Thermal cell damage	Non-thermal cell damage
Tissue selectivity	Nonselective	Nonselective	Selective
Catheters footprint	Balloon	Balloon & Point-by-point	Different footprints
Time to ablation effect	Time-needed thermal effect	Time-needed thermal effect	Instant electroporation
Patient preparation	Deep sedation or GA	Deep sedation or GA	Deep sedation or GA
Fluoroscopy	Majority needed	Majority needed	Needed
3-D mapping integration	No	Yes	With or without
First pass PVI	> 98%	98%	~100%
Ablation time	++	++	+
Single-shot isolation	+	+	++
Ablation beyond PVs	No	Yes	Possible
Adjacent tissue damage*	Yes	Yes	No
Pericardial injury	Rare	+	No
Esophageal fistula	No	+	No
Phrenic nerve palsy	+ (usually transient)	Rare	No
Coronary artery injury	No	Possible	+ (spasm with pentaspline)
Hemolysis	No	No	Possible
Durability at 1 year	60–73%	70–90%	70–90%

^*Vessels, nerves, esophagus

Abbreviations: CBA, cryoballoon ablation; FDA, Food and Drug Administration; GA, general anesthesia; PFA, pulsed-field ablation; PVI, pulmonary vein isolation; PVs, pulmonary veins; RFA, radiofrequency ablation.

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