title: Increased rate of observed real-time pulmonary vein isolation with third-generation short-tip cryoballoon.
abstract: OBJECTIVE
  Pulmonary vein isolation (PVI) with the cryoballoon is an established treatment for symptomatic atrial fibrillation. The second-generation cryoballoon increased efficacy in comparison to the first-generation cryoballoon. The third-generation cryoballoon was designed with a shorter distal tip to facilitate real-time recording of pulmonary vein (PV) isolation. Here, we compared the rate of real-time recordings of PVI of the second- and third-generation cryoballoon.
  
  
  METHODS
  The incidence of real-time recording of PV isolation and time to PV isolation of the first 37 patients treated with the new third-generation cryoballoon at our center were compared to the last 37 patients treated with the second-generation cryoballoon.
  
  
  RESULTS
  One hundred forty-nine pulmonary veins (PVs) were identified in each group. All PVs were isolated successfully with the second- or third-generation cryoballoon. Real-time registration of PVI occurred in 83 PVs (55.7 %) with the second-generation cryoballoon and in 124 PVs (83.2 %) with the third-generation cryoballoon (p < 0.001). The rate of observed real-time PVI was significantly higher with the third-generation cryoballoon for each individual PV. The time-to-isolation was 44 ± 25 s with the second-generation cryoballoon vs. 42 ± 22 s with the third-generation cryoballoon (p = 0.25). In a short-term clinical follow-up, there was no significant difference in atrial arrhythmia recurrence rates between both groups.
  
  
  CONCLUSIONS
  The third-generation cryoballoon facilitates real-time recording of PV isolation with significantly higher rates of observed time-to-isolation. The time to PV isolation is not different between second- and third-generation cryoballoon.
authors.affiliation: Department of Medicine II, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Pott
authors.affiliation: Department of Medicine II, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Petscher
authors.affiliation: Department of Medicine II, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
authors.forename: Marvin
authors.initials: M
authors.lastname: Messemer
authors.affiliation: Department of Medicine II, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rottbauer
authors.affiliation: Department of Medicine II, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany. tillman.dahme@uniklinik-ulm.de.
authors.forename: Tillman
authors.initials: T
authors.lastname: Dahme
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000706:statistics & numerical data; D003452:Cryosurgery / Q000295:instrumentation* / Q000706:statistics & numerical data; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005858:Germany / Q000453:epidemiology; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D061646:Operative Time; D015995:Prevalence; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Ablation; Atrial fibrillation; Cryoballoon; Short tip; Time-to-isolation