title: Cryoballoon ablation as index procedure for paroxysmal atrial fibrillation: long-term results from a single center early experience.
abstract: OBJECTIVE
  Cryoballoon ablation (CRAB) as a modality for pulmonary vein isolation (PVI) is increasingly being accepted. We aim to study the long-term durability of CRAB in atrial fibrillation.
  
  
  METHODS
  The first 51 consecutive patients with documented paroxysmal atrial fibrillation(PAF) who underwent CRAB at our institute were considered. Forty patients formed the study group. Successful PVI was achieved in all the patients. Patients were evaluated with Holter ECG recordings at 1, 3, 6 and 12 months and subsequent follow-up was biannual and based on the clinical status and physician discretion whether symptoms occurred. For the study purpose, a baseline ECG, a 24-h Holter and clinical evaluation were performed in all patients at final follow-up.
  
  
  RESULTS
  A large 28-mm cryoballoon (CB) was used in 38 patients (95%), and the small 23-mm CB in the remaining two individuals (2%). The freedom from atrial fibrillation off-antiarrhythmic drug treatment (AAD) after a single procedure at a mean follow-up of 36.6 ± 4 months was 57.5% (23/40). Transient right phrenic nerve palsy was the most common complication.
  
  
  CONCLUSIONS
  Single balloon size CRAB provides a durable atrial fibrillation-free-AAD-free survival in drug-resistant PAF patients over long-term follow-up with a success rate of 57.5% with a single procedure.
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium *These authors have contributed equally to the manuscript.
authors.forename: Jayakeerthi Yoganarasimha
authors.initials: JY
authors.lastname: Rao
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.forename: Ruben
authors.initials: R
authors.lastname: Casado-Arroyo
authors.forename: Ingrid
authors.initials: I
authors.lastname: Overeinder
authors.forename: Andrea
authors.initials: A
authors.lastname: Sarkozy
authors.forename: Gaetano
authors.initials: G
authors.lastname: Paparella
authors.forename: Lucio
authors.initials: L
authors.lastname: Capulzini
authors.forename: Antonio
authors.initials: A
authors.lastname: Sorgente
authors.forename: Moises
authors.initials: M
authors.lastname: Rodriguez-Manero
authors.forename: Danilo
authors.initials: D
authors.lastname: Ricciardi
authors.forename: Mehdi
authors.initials: M
authors.lastname: Namdar
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000601:surgery*; D021721:Balloon Occlusion / Q000009:adverse effects / Q000379:methods*; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D004351:Drug Resistance; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents