title: One-year clinical outcome after pulmonary vein isolation using the second-generation 28-mm cryoballoon.
abstract: BACKGROUND
  The use of second-generation cryoballoon for pulmonary vein isolation in patients with paroxysmal atrial fibrillation has demonstrated encouraging acute and mid-term results. Long-term outcome data are not yet available.
  
  
  RESULTS
  Fifty patients (18 women; mean age, 61±11 years; mean left atrial diameter, 43±5 mm) with paroxysmal (36 of 50 patients; 72%) or short-standing (<3-month duration) persistent atrial fibrillation (14 of 50 patients; 28%) underwent cryoballoon-based pulmonary vein isolation. Freeze cycle duration was 240 seconds. After successful pulmonary vein isolation, a bonus freeze was applied. Follow-up was based on outpatient clinic visits at 3, 6, and 12 months including Holter-ECGs and telephonic interviews. Recurrence was defined as a symptomatic or documented arrhythmia episode>30 seconds excluding a 3-month blanking period. A total of 192 pulmonary veins were identified, and 191 of 192 (99%) pulmonary veins were successfully isolated. Phrenic nerve palsy occurred in 1 of 50 (2%) patients. Follow-up was available for 49 of 50 (98%) patients with a mean follow-up duration of 440±39 days. Thirty-nine of 49 (80%) patients remained in stable sinus rhythm. Of 8 of 10 patients with arrhythmia recurrence, a second procedure using radiofrequency ablation demonstrated left atrial to pulmonary vein reconduction.
  
  
  CONCLUSIONS
  The use of second-generation 28-mm cryoballoon for pulmonary vein isolation results in an 80% 1-year success rate.
authors.affiliation: Department of Cardiology, AsklepiosKlinik St Georg, Hamburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Metzner
authors.forename: Bruno
authors.initials: B
authors.lastname: Reissmann
authors.forename: Peter
authors.initials: P
authors.lastname: Rausch
authors.forename: Shibu
authors.initials: S
authors.lastname: Mathew
authors.forename: Peter
authors.initials: P
authors.lastname: Wohlmuth
authors.forename: Roland
authors.initials: R
authors.lastname: Tilz
authors.forename: Andreas
authors.initials: A
authors.lastname: Rillig
authors.forename: Christine
authors.initials: C
authors.lastname: Lemes
authors.forename: Sebastian
authors.initials: S
authors.lastname: Deiss
authors.forename: Christian
authors.initials: C
authors.lastname: Heeger
authors.forename: Masashi
authors.initials: M
authors.lastname: Kamioka
authors.forename: Tina
authors.initials: T
authors.lastname: Lin
authors.forename: Feifan
authors.initials: F
authors.lastname: Ouyang
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Erik
authors.initials: E
authors.lastname: Wissner
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods; D003452:Cryosurgery / Q000295:instrumentation*; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D016896:Treatment Outcome
keywords: ablation; atrial fibrillation; follow-up studies