title: Regular atrial tachycardias following pulmonary vein isolation for paroxysmal atrial fibrillation: a retrospective comparison between the cryoballoon and conventional focal tip radiofrequency techniques.
abstract: OBJECTIVE
  Occurrence of atrial tachycardias (ATs) following radiofrequency (RF) pulmonary vein (PV) isolation for the treatment of paroxysmal atrial fibrillation (PAF) is a frequent complication. Cryoballoon (CB) ablation might create more homogeneous and demarcated lesions than traditional point by point RF approach, hypothetically leading to a lower incidence of ATs. Our aim is to compare incidence and mechanism of regular ATs occurring after ablation of PAF by means of circumferential point by point RF vs CB ablation.
  
  
  METHODS
  Two hundred eighty-six consecutive patients undergoing a first PV isolation procedure, as treatment for PAF, were included and followed up for 12 months. Point by point RF ablation was performed in 186 patients and CB ablation in the remaining 100. Among the last ones, first generation (CB-1) was used in 59 patients and second generation one (CB-2) in 41.
  
  
  RESULTS
  Incidence of regular ATs was higher following RF PV isolation when compared with CB ablation (11.3 vs 3.0%, P = 0.028). When compared separately with RF ablation, both CB-1 and CB-2 presented lower incidences of ATs (5.1 and 0.0%) but differences only remained significant for the CB-2 (P = 0.027).
  
  
  CONCLUSIONS
  Patients with PAF undergoing a first PV isolation procedure by means of CB ablation present a significantly lower incidence of ATs than those in which PV isolation is achieved by means of circumferential point by point RF ablation.
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium, justojc@hotmail.com.
authors.forename: Justo
authors.initials: J
authors.lastname: Juliá
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.forename: Giacomo
authors.initials: G
authors.lastname: Mugnai
authors.forename: Juan
authors.initials: J
authors.lastname: Sieira
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciconte
authors.forename: Giacomo
authors.initials: G
authors.lastname: Di Giovanni
authors.forename: Giulio
authors.initials: G
authors.lastname: Conte
authors.forename: Giannis
authors.initials: G
authors.lastname: Baltogiannis
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.forename: Kristel
authors.initials: K
authors.lastname: Wauters
authors.forename: Ghazala
authors.initials: G
authors.lastname: Irfan
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D003452:Cryosurgery / Q000295:instrumentation / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D011667:Pulmonary Veins / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome