title: Comparison of pulmonary vein isolation using cryoballoon versus conventional radiofrequency for paroxysmal atrial fibrillation.
abstract: The aim of this study was to compare the results of pulmonary vein isolation using conventional irrigated radiofrequency (RF) approach versus the cryoballoon (CB) ablation. From January 2008 to December 2011, a total of 426 patients with drug-resistant symptomatic paroxysmal atrial fibrillation underwent pulmonary vein isolation as the index procedure by conventional manual RF or CB ablation at our center. A final population of 396 patients was considered for analysis and divided into 2 groups: conventional RF ablation (n = 260) and CB ablation (n = 136). At a mean follow-up of 23 ± 13 months (median 27, range 4 to 68), the success rate for RF ablation group was 57.3% (149 patients) and was 63.2% (86 patients) for cryoablation group (p = 0.25). Procedural times were significantly shorter in the cryoablation group (192 ± 49 vs 112 ± 58 minutes, p <0.000001) but not fluoroscopy times (36 ± 14 vs 31 ± 17 minutes, p = 0.45). No clinical predictors were found to predict atrial fibrillation recurrences. Complication rates were similar in both groups except for phrenic nerve palsy that was uniquely observed in the CB group (8.1%, p <0.00001). All phrenic nerve palsies resolved during follow-up. In conclusion, on a medium-term follow-up, conventional point-by-point RF ablation and CB ablation showed similar success rates. Procedural times were significantly shorter in the CB approach. The most frequent complication during CB procedures was phrenic nerve palsy, which occurred in 8.1% of patients and resolved in all during the follow-up period.
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium; Department of Cardiology, University Hospital of Verona, Verona, Italy. Electronic address: mugnai.giacomo@gmail.com.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Mugnai
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Juan
authors.initials: J
authors.lastname: Sieira-Moret
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Giulio
authors.initials: G
authors.lastname: Conte
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Lucio
authors.initials: L
authors.lastname: Capulzini
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Kristel
authors.initials: K
authors.lastname: Wauters
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Moises
authors.initials: M
authors.lastname: Rodriguez-Mañero
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Di Giovanni
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Giannis
authors.initials: G
authors.lastname: Baltogiannis
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciconte
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Justo
authors.initials: J
authors.lastname: Juliá
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010791:Phrenic Nerve / Q000293:injuries; D011183:Postoperative Complications; D011667:Pulmonary Veins / Q000601:surgery*; D016896:Treatment Outcome