title: Medium-term results of cryoballoon ablation of the pulmonary veins in patients with paroxysmal and persistent atrial fibrillation. First experience of a Spanish center.
abstract: OBJECTIVE
  Cryoballoon ablation of the pulmonary veins (CAPV) is a new technique that could have similar results to radiofrequency procedures, but with fewer complications. We analyzed the outcomes and safety of this technique in a consecutive cohort of patients with atrial fibrillation (AF).
  
  
  METHODS
  A total of 63 patients with paroxysmal (n = 40) or persistent (n = 23) AF were studied. Patient follow-up was performed at 3 months and then every 6 months with 72-h continuous electrocardiographic recordings.
  
  
  RESULTS
  A total of 262 pulmonary veins were treated; 60.3 % of the cases presented normal pulmonary vein drainage with 4 pulmonary veins, and 23.8 % of the cases presented a common left-sided antrum. Complete isolation of all veins was achieved in 95.2 % of cases with 10.3 ± 2.8 (mean ± standard deviation) applications per patient. Transient right phrenic nerve injury was the most common complication (4.7 %). Median follow-up was 5.5 months. The probability of being free of recurrence at 1 and 2 years was, respectively, 86.2 and 72.2 % for paroxysmal AF and 49 and 36.4 % for persistent AF (P = 0.012). Patients with structural heart disease experienced recurrence more often than patients with a normal heart (62.5 versus 24.5 %; P = 0.03).
  
  
  CONCLUSIONS
  CAPV appears to be a safe and effective procedure for the treatment of patients with AF, particularly those with paroxysmal AF and no structural heart disease.
authors.affiliation: Arrhythmia Unit, Cardiology Department, Hospital Clínico Universitario de Valencia, Avda Blasco Ibáñez 17, 46010 Valencia, Spain. angelferrero@hotmail.com
authors.forename: Angel
authors.initials: A
authors.lastname: Ferrero-de Loma-Osorio
authors.forename: Maite
authors.initials: M
authors.lastname: Izquierdo-de Francisco
authors.forename: Angel
authors.initials: A
authors.lastname: Martínez-Brotons
authors.forename: Juan M
authors.initials: JM
authors.lastname: Sánchez-Gómez
authors.forename: Beatriz
authors.initials: B
authors.lastname: Mascarell-Gregori
authors.forename: Vicente
authors.initials: V
authors.lastname: Ruiz-Ros
authors.forename: Isabel
authors.initials: I
authors.lastname: Cuenca-Romero
authors.forename: Roberto
authors.initials: R
authors.lastname: García-Civera
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Chorro-Gascó
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ruiz-Granell
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D006328:Cardiac Catheterization / Q000401:mortality* / Q000706:statistics & numerical data*; D015331:Cohort Studies; D015897:Comorbidity; D003452:Cryosurgery / Q000401:mortality*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010865:Pilot Projects; D011183:Postoperative Complications / Q000401:mortality*; D015995:Prevalence; D011667:Pulmonary Veins / Q000601:surgery*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome