title: [Advances in cryoballoon technology: benefits and risks in daily practice].
abstract: BACKGROUND
  Cryoballoon ablation is nowadays a standard approach for pulmonary vein isolation in symptomatic atrial fibrillation. The second generation cryoballoon was introduced in 2012 and modifications and enhancement to the system promised a higher efficiency.
  
  
  OBJECTIVE
  A comprehensive overview of advances in cryoballoon ablation is provided and the consequences for daily practice are described based on a PubMed literature search, taking into account own experiences.
  
  
  CONCLUSIONS
  Advances in cryoballoon ablation result in a significantly higher efficiency. To maintain the overall safety of the procedure and to avoid phrenic nerve palsy and esophageal lesions, special care needs to be taken by following some safety aspects and cut-off criteria. More data are necessary to clarify if recommendations for cryoenergy titration with the new balloon are reasonable. Ongoing prospective studies comparing cryoballoon and radiofrequency (RF) ablation will give answers to the question which energy source is more favorable, and upcoming studies will evaluate the impact of cryoballoon ablation as a first line treatment option.
authors: Klinik für Kardiologie und internistische Intensivmedizin, Klinikum Bogenhausen, Städtisches Klinikum München GmbH, Englschalkinger Straße 77, 81925, München, Deutschland, florian.straube@klinikum-muenchen.de.
authors: Florian
authors: F
authors: Straube
authors: Uwe
authors: U
authors: Dorwarth
authors: Ellen
authors: E
authors: Hoffmann
mesh_terms: D001281:Atrial Fibrillation / Q000628:therapy*; D006328:Cardiac Catheterization / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D002908:Chronic Disease; D003452:Cryosurgery / Q000379:methods*; D019317:Evidence-Based Medicine; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D011667:Pulmonary Veins / Q000601:surgery*; D016896:Treatment Outcome