title: Two years outcome in patients with persistent atrial fibrillation after pulmonary vein isolation using the second-generation 28-mm cryoballoon.
abstract: The efficacy of the second-generation cryoballoon (CB) in patients with paroxysmal atrial fibrillation (AF) has been demonstrated previously. Data on the efficacy of CB ablation in patients with persistent AF are sparse.
  
  
  
  The aim of this study was to evaluate the 2-year success rate of pulmonary vein isolation in patients with persistent AF using the second-generation CB.
  
  
  
  Fifty consecutive patients (mean age 64.6 ± 9.9 years; 19 women [38%]) with persistent AF were included in this analysis. The mean follow-up period was 22 ± 11 months. All patients were ablated using the second-generation 28-mm CB. Isolation of the pulmonary veins was confirmed using a spiral mapping catheter. In all patients, follow-up was obtained using 24-hour Holter monitoring or via interrogation of an implanted loop recorder or pacemaker.
  
  
  
  The mean left atrial diameter was 43.6 ± 5.6 mm, the mean CHA2DS2-VASc score was 2.8 ± 1.5, and the mean HAS-BLED score was 2.1 ± 1.2. The mean fluoroscopy time was 25.8 ± 9 minutes, and the mean procedural time was 146.4 ± 37.8 minutes. After 22 ± 11 months, the frequency of arrhythmia recurrence was 22 of 50 (44%) in the overall group (paroxysmal AF 6 of 22 [27%]; persistent AF 16 of 22 [73%]). No major complications occurred. Aneurysma spurium not requiring surgical intervention occurred in 1 (2%) patient. No phrenic nerve palsy was observed.
  
  
  
  Two years' results after pulmonary vein isolation using the second-generation CB in patients with persistent AF are promising. The clinical success rate appears to be similar to the reported success rates of radiofrequency ablation for the treatment of persistent AF.
authors.affiliation: Department of Cardiology, Campus Benjamin Franklin, Charité Universitaetsmedizin Berlin, Berlin, Germany. Electronic address: verena.tscholl@charite.de.
authors.forename: Verena
authors.initials: V
authors.lastname: Tscholl
authors.affiliation: Department of Cardiology, Campus Benjamin Franklin, Charité Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Abdullah Khaled-A
authors.initials: AK
authors.lastname: Lsharaf
authors.affiliation: Heart Care Victoria, Genesis Care, Melbourne, Australia.
authors.forename: Tina
authors.initials: T
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Campus Benjamin Franklin, Charité Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bellmann
authors.affiliation: Department of Cardiology, Campus Benjamin Franklin, Charité Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Biewener
authors.affiliation: Department of Cardiology, Campus Benjamin Franklin, Charité Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Nagel
authors.affiliation: Department of Cardiology, Campus Benjamin Franklin, Charité Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Saba
authors.initials: S
authors.lastname: Suhail
authors.affiliation: Institute for Biometry and Clinical Epidemiology, Campus Benjamin Franklin, Charité Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Lenz
authors.affiliation: Department of Cardiology, Campus Benjamin Franklin, Charité Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Landmesser
authors.affiliation: Department of Cardiology, Campus Benjamin Franklin, Charité Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Mattias
authors.initials: M
authors.lastname: Roser
authors.affiliation: Department of Cardiology, Campus Benjamin Franklin, Charité Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rillig
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000601:surgery*; D003452:Cryosurgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Catheter ablation; Cryoballon ablation; Efficacy; Long-term outcome; Persistent atrial fibrillation; Second generation