title: Electrophysiological findings following pulmonary vein isolation using radiofrequency catheter guided by contact-force and second-generation cryoballoon: lessons from repeat ablation procedures.
abstract: OBJECTIVE
  To assess the incidence of late pulmonary vein (PV) reconnection following index PV isolation (PVI) procedure initially achieved with radiofrequency contact-force catheter ablation (CFCA) and second-generation cryoballoon ablation (CB-AdvA).
  
  
  RESULTS
  A total of 56 consecutive patients (41 male, 73.2%; mean age 60.8 ± 11.8 years) underwent a repeat ablation because of recurrent atrial tachyarrhythmias (ATas) after index PVI achieved with CFCA (30 patients) or CB-AdvA (26 patients). All repeat procedures were performed by the means of CFCA. In the CFCA group, among 119 PVs, 43 (36.1%) showed conduction gaps in 24 patients (1.8 per patient), whereas in the CB-AdvA group among 103 veins, 21 (20.4%) showed a PV reconnection in 18 patients (1.2 per patient) (P = 0.01). The left superior pulmonary vein was less frequently reconnected following CB-AdvA when compared with CFCA (2/25, 8% vs. 11/29, 37.9%; P = 0.01). In the CFCA group, the mean CF per-vein was lower in reconnecting veins when compared with those persistently isolated (10.9 ± 2.7 vs. 18.6 ± 3.1 g; P < 0.001). In the CB-AdvA group, late PV reconnection was associated with warmer nadir temperature (-48.9 ± 5.1 vs. -51.2 ± 4.7°C; P = 0.05) and longer time-to-isolation (71.1 ± 20.2 vs. 50.2 ± 32.9 s; P = 0.03).
  
  
  CONCLUSIONS
  The rate of late PV reconnection is significantly lower following CB-AdvA when compared with CFCA as index procedure. Lower CF values and warmer nadir temperature with longer time to effect were more frequently associated with PV reconnections in the setting of CFCA and CB-AdvA.
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium g.ciconte@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciconte
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Vedran
authors.initials: V
authors.lastname: Velagić
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Mugnai
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Ghazala
authors.initials: G
authors.lastname: Irfan
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Burak
authors.initials: B
authors.lastname: Hunuk
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Erwin
authors.initials: E
authors.lastname: Ströker
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Giulio
authors.initials: G
authors.lastname: Conte
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Juan
authors.initials: J
authors.lastname: Sieira
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Di Giovanni
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Giannis
authors.initials: G
authors.lastname: Baltogiannis
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, Brussels 1090, Belgium.
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping; D006328:Cardiac Catheterization / Q000295:instrumentation; D017115:Catheter Ablation / Q000295:instrumentation*; D003452:Cryosurgery / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012086:Reoperation; D013314:Stress, Mechanical; D014110:Touch; D016896:Treatment Outcome
keywords: Atrial fibrillation; Contact-force radiofrequency catheter ablation; Cryoballoon ablation; Pulmonary vein isolation; Pulmonary vein reconnection; Second-generation cryoballoon