Improved lesion formation using the novel 28 mm cryoballoon in atrial fibrillation ablation: analysis of biomarker release.
OBJECTIVE
Recently, a novel second-generation (G2) cryoballoon (CB) was introduced. Comparative analysis of lesion formation in terms of myocardial biomarker release [first-generation CB (G1) vs. G2] has not been studied. To compare myocardial biomarker release using the 28 mm G1 vs. G2 CB.


RESULTS
In patients (patients) treated with the simplified single big CB (SBCB) strategy for pulmonary vein isolation (PVI), myocardial biomarkers [troponin T (TnT), creatine kinase, lactic dehydrogenase (LDH)] were measured at 12, 24, and 48 h after PVI. Two groups were defined: Group 1 (G1; freezing time: 300 s), Group 2 (G2; freezing time: 240 s). Mean biomarker peak values were compared. To correct for between-group differences in cumulative freezing time, an index calculated as peak biomarker release divided by cumulative freezing time was calculated. Sixty-six CB PVI procedures (G1: 33 patients, G2: 33 patients) were analysed. Pulmonary vein isolation was achieved in all the patients using the simplified SBCB technique only. Mean freezing time (51 ± 10 vs. 33 ± 6 min, P < 0.01) was significantly shorter in G2. All biomarker levels tended to be higher in G2 vs. G1. The indexed biomarkers values were significantly higher in G2: TnT: 18.8 ± 8.5 vs. 32.3 ± 13.6 pg/L/min (P < 0.01); creatinephosphokinase: 6.7 ± 2.7 vs. 11.7 ± 3.9 U/L/min (P < 0.01); LDH: 5.2 ± 1.0 vs. 9.1 ± 2.7 U/L/min (P < 0.01). On a 6-month follow-up (180 days), G2 revealed a significantly higher success rate (20/33 vs. 28/33; P = 0.027).


CONCLUSIONS
Pulmonary vein isolation using the G2 CB increased the myocardial biomarker release index and is linked to a significantly improved 6 months success rate.
CCB-Cardioangiologisches Centrum Bethanien, Markuskrankenahus, Wilhelm-Epstein Street 4, 60431 Frankfurt/Main, Germany.
Stefano
S
Bordignon
CCB-Cardioangiologisches Centrum Bethanien, Markuskrankenahus, Wilhelm-Epstein Street 4, 60431 Frankfurt/Main, Germany.
Alexander
A
Fürnkranz
CCB-Cardioangiologisches Centrum Bethanien, Markuskrankenahus, Wilhelm-Epstein Street 4, 60431 Frankfurt/Main, Germany.
Daniela
D
Dugo
CCB-Cardioangiologisches Centrum Bethanien, Markuskrankenahus, Wilhelm-Epstein Street 4, 60431 Frankfurt/Main, Germany.
Laura
L
Perrotta
CCB-Cardioangiologisches Centrum Bethanien, Markuskrankenahus, Wilhelm-Epstein Street 4, 60431 Frankfurt/Main, Germany.
Melanie
M
Gunawardene
Universitätsklinikum Medizinische Klinik II, Ratzeburger Allee 160, D-23562 Lübeck.
Frank
F
Bode
CCB-Cardioangiologisches Centrum Bethanien, Markuskrankenahus, Wilhelm-Epstein Street 4, 60431 Frankfurt/Main, Germany.
Anne
A
Klemt
CCB-Cardioangiologisches Centrum Bethanien, Markuskrankenahus, Wilhelm-Epstein Street 4, 60431 Frankfurt/Main, Germany.
Bernd
B
Nowak
CCB-Cardioangiologisches Centrum Bethanien, Markuskrankenahus, Wilhelm-Epstein Street 4, 60431 Frankfurt/Main, Germany.
Britta
B
Schulte-Hahn
CCB-Cardioangiologisches Centrum Bethanien, Markuskrankenahus, Wilhelm-Epstein Street 4, 60431 Frankfurt/Main, Germany.
Boris
B
Schmidt
CCB-Cardioangiologisches Centrum Bethanien, Markuskrankenahus, Wilhelm-Epstein Street 4, 60431 Frankfurt/Main, Germany j.chun@ccb.de.
K R Julian
KR
Chun
D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D062906:Cardiac Catheters; D003402:Creatine Kinase / Q000097:blood*; D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D020107:Troponin T; D007770:L-Lactate Dehydrogenase; D003402:Creatine Kinase
Atrial fibrillation; Cardiac biomarker; Cryoablation