Second-generation cryoballoon ablation for paroxysmal atrial fibrillation: 1-year follow-up.
BACKGROUND
The novel cryoballoon Advance (CB-A) has proven to achieve significantly lower temperatures and faster pulmonary vein isolation (PVI) times in comparison with the first-generation device. Although acutely very effective, to the best of our knowledge, data on mid-term clinical follow-up is lacking.


OBJECTIVE
The aim of the study was to analyse the freedom from recurrence of atrial fibrillation (AF) on a 1-year follow-up period, in a series of consecutive patients having undergone PVI with the CB-A for paroxysmal AF (PAF).


RESULTS
Forty-two patients [30 male (71%); mean age: 57.9 ± 21.1 years] were included. All patients underwent a procedure with the large 28 mm CB-A. A total 168 PVs were depicted on the pre-procedural computed tomography scan. All PVs (100%) could be isolated with the CB only. The freedom from AF off-antiarrhythmic drug treatment after a single procedure was 78% of patients at a mean 11.6 ± 2.0 months follow-up. If considering a blanking period (BP) of 3 months, success rate was 83%. Phrenic nerve palsy (PNP) was the most frequent complication occurring in 19% of individuals.


CONCLUSIONS
The CB-A is very effective in producing PVI and affords freedom from AF at 12 months follow-up in 83% of patients affected by drug-resistant PAF following a 3-month BP. The most frequent complication observed was PNP which occurred in 19% of patients. All PNP reverted during follow-up.
Heart Rhythm Management Center, UZ Brussel-VUB, Laarbbeklaan 101, 1090 Brussels, Belgium.
Gian-Battista
GB
Chierchia
Giacomo
G
Di Giovanni
Giuseppe
G
Ciconte
Carlo
C
de Asmundis
Giulio
G
Conte
Juan
J
Sieira-Moret
Moises
M
Rodriguez-Mañero
Ruben
R
Casado
Giannis
G
Baltogiannis
Mehdi
M
Namdar
Yukio
Y
Saitoh
Gaetano
G
Paparella
Giacomo
G
Mugnai
Pedro
P
Brugada
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D015331:Cohort Studies; D003452:Cryosurgery / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
Atrial fibrillation; Cryoballoon; Mid-term outcomes; Pulmonary vein isolation