A cryogenic ablation catheter 12 includes a catheter shaft 16, a balloon 24 and a connector 30 respectively at the catheter shaft proximal and distal ends 18, 20, a refrigerant delivery tube assembly including a refrigerant delivery tube 34 rotatable within the catheter shaft lumen 22, and a refrigerant delivery element 40 with an outlet 42 located inside the balloon which directs refrigerant 44 outwardly against the balloon at different rotary positions as it rotates. A cryogenic balloon ablation system 10 includes the cryogenic ablation catheter, a catheter coupler 119 mating with the connector, a motor 104 including a rotatable hollow motor shaft 102, and a delivery line 100 fluidly coupled to a cryogenic gas source 84 for supplying cryogenic gas to the refrigerant delivery tube. At least one of the refrigerant delivery tube and the delivery line passes at least partway through the hollow motor shaft. The coupling tip 60 of the connector and the refrigerant delivery tube 34 rotate with the motor shaft 102.