title: Initial experience of three-minute freeze cycles using the second-generation cryoballoon ablation: acute and short-term procedural outcomes.
abstract: BACKGROUND
  The second-generation cryoballoon (CB-A) (Arctic Front Advance, Cryocath, Medtronic, MN, USA) might significantly improve procedural outcome with respect to the first-generation balloon. These technological improvements might also question the current recommendation of the need a 4-min freeze to achieve durable pulmonary vein isolation (PVI).
  
  
  OBJECTIVE
  The main aim of the study was to analyze the procedural efficacy of a 3-min freeze-thaw cycles with the CB-A balloon in the terms of rates of acute PVI and 6-month outcome.
  
  
  METHODS
  Patients having undergone CB-A for PAF or early persistent AF, with 3-min freeze-thaw cycles were consecutively included in our analysis. Acute procedural success was measured in terms of the rate of PVI. Short-term follow-up was evaluated by the means of 24-h Holters and clinical examinations at regular intervals.
  
  
  RESULTS
  Fifty-two consecutive patients (35 male (67 %); mean age, 59.8 ± 10.5) were included. Mean procedure and fluoroscopy times were 96 ± 15 and 13.2 ± 8.3 min, respectively. Mean time from groin puncture to catheter extraction was 60.4 ± 20 min. After a mean of 1.5 freeze cycles per vein of 3 min in duration, all 208 (100 %) PVs could be isolated with the CB-A. A total 192 (91 %) veins were isolated during the first freeze. At a mean of 5.7-month follow-up, 82 % of patients were free of AF.
  
  
  CONCLUSIONS
  CB-A is effective in producing PVI by using 3-min-duration freeze cycles. After a mean of 1.5 freeze per vein, freedom from AF was achieved in 82 % of patients at 6-month follow-up.
authors: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, 1090, Brussels, Belgium, gbchier@yahoo.it.
authors: Gian-Battista
authors: GB
authors: Chierchia
authors: Giacomo
authors: G
authors: Di Giovanni
authors: Juan
authors: J
authors: Sieira-Moret
authors: Carlo
authors: C
authors: de Asmundis
authors: Giulio
authors: G
authors: Conte
authors: Moises
authors: M
authors: Rodriguez-Mañero
authors: Ruben
authors: R
authors: Casado-Arroyo
authors: Giannis
authors: G
authors: Baltogiannis
authors: Gaetano
authors: G
authors: Paparella
authors: Giuseppe
authors: G
authors: Ciconte
authors: Andrea
authors: A
authors: Sarkozy
authors: Pedro
authors: P
authors: Brugada
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures / Q000379:methods*; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010865:Pilot Projects; D011667:Pulmonary Veins / Q000601:surgery*; D016896:Treatment Outcome