title: Improved 1-year clinical success rate of pulmonary vein isolation with the second-generation cryoballoon in patients with paroxysmal atrial fibrillation.
abstract: BACKGROUND
  The second-generation cryoballoon (CB2) has recently been introduced featuring improved surface cooling. Increased procedural efficacy of pulmonary vein isolation (PVI) when compared to the first-generation balloon (CB1) has been reported. The aim of the study was to investigate the clinical outcome of cryoballoon PVI after 1 year using the CB2 as compared to the CB1.
  
  
  RESULTS
  A total of 105 consecutive patients with paroxysmal atrial fibrillation (AF) were studied. Cryoballoon PVI (28 mm) was performed in 50 patients using the CB1, and in 55 patients using the CB2. Patients were scheduled for 72-hour Holter ECG recording at 3, 6, 9, and 12 months and every 6 months thereafter. The study endpoint was defined as recurrent AF or atrial tachycardia >30 seconds documented after a blanking period of 90 days after the procedure. Complete PVI was achieved in 49/50 (98%) and 55/55 (100%) patients in the CB1 and CB2 group, respectively. After a mean follow-up of 416 ± 75 days, 21 (CB1 group) and 10 (CB2 group) patients reached the study endpoint. Kaplan-Meier estimates of arrhythmia-free survival after a single procedure without AAD therapy after 1 year were 63.9% versus 83.6% (P = 0.008) in the CB1 and CB2 group, respectively. Persistent phrenic nerve palsy with delayed healing occurred in 2 (CB1 group) and 3 (CB2 group) patients.
  
  
  CONCLUSIONS
  Clinical outcome of PVI using the CB2 was significantly improved when compared to the CB1.
authors.affiliation: Cardioangiologisches Centrum Bethanien, Medizinische Klinik III, Markus Krankenhaus, Frankfurt, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Fürnkranz
authors.affiliation: Cardioangiologisches Centrum Bethanien, Medizinische Klinik III, Markus Krankenhaus, Frankfurt, Germany.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bordignon
authors.affiliation: Cardioangiologisches Centrum Bethanien, Medizinische Klinik III, Markus Krankenhaus, Frankfurt, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Dugo
authors.affiliation: Cardioangiologisches Centrum Bethanien, Medizinische Klinik III, Markus Krankenhaus, Frankfurt, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Perotta
authors.affiliation: Cardioangiologisches Centrum Bethanien, Medizinische Klinik III, Markus Krankenhaus, Frankfurt, Germany.
authors.forename: Melanie
authors.initials: M
authors.lastname: Gunawardene
authors.affiliation: Cardioangiologisches Centrum Bethanien, Medizinische Klinik III, Markus Krankenhaus, Frankfurt, Germany.
authors.forename: Britta
authors.initials: B
authors.lastname: Schulte-Hahn
authors.affiliation: Cardioangiologisches Centrum Bethanien, Medizinische Klinik III, Markus Krankenhaus, Frankfurt, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Nowak
authors.affiliation: Cardioangiologisches Centrum Bethanien, Medizinische Klinik III, Markus Krankenhaus, Frankfurt, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Schmidt
authors.affiliation: Cardioangiologisches Centrum Bethanien, Medizinische Klinik III, Markus Krankenhaus, Frankfurt, Germany.
authors.forename: Julian K R
authors.initials: JKR
authors.lastname: Chun
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation*; D018572:Disease-Free Survival; D015716:Electrocardiography, Ambulatory; D004867:Equipment Design; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000209:etiology; D059348:Peripheral Nerve Injuries / Q000209:etiology; D010791:Phrenic Nerve / Q000293:injuries; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D013617:Tachycardia, Supraventricular / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: atrial fibrillation; catheter ablation; cryoballoon; phrenic nerve palsy; pulmonary vein isolation