title: Second generation cryoballoon ablation for atrial fibrillation in young adults: midterm outcome in patients under 40 years of age.
abstract: Pulmonary vein isolation (PVI) has been demonstrated more effective in young patients, in which the substrate for atrial fibrillation (AF) is probably more confined to pulmonary vein potentials. The present study sought to focus on the midterm outcomes in patients under 40 years having undergone PVI with the Cryoballoon Advance because of drug resistant AF.
  
  
  
  Between June 2012 and December 2015, 57 patients having undergone Cryoballoon ablation (CB-A) below 40 years of age for AF in our centre were retrospectively analysed and considered for our analysis. All patients underwent this procedure with the 28 mm Cryoballon Advance. All 227 veins were successfully isolated without the need for additional focal tip ablation. Median follow-up was 18 ±10 months. The freedom from AF after a blanking period of 3 months was 88% in our cohort of patients younger than 40 years old. The most frequent periprocedural complication was related to the groin puncture and occurred in 2 patients. After a single procedure, the only univariate predictor of clinical recurrence was the diagnosis of hypertrophic cardiomyopathy.
  
  
  
  Young patients affected by AF can be effectively and safely treated with CB-A that grants freedom from AF in 88% of the patients at 18 months follow-up following a 3-month blanking period. All veins could be isolated with the large 28 mm Cryoballoon Advance only.
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Darragh
authors.initials: D
authors.lastname: Moran
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Valentina
authors.initials: V
authors.lastname: De Regibus
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Ken
authors.initials: K
authors.lastname: Takarada
authors.forename: Giacomo
authors.initials: G
authors.lastname: Mugnai
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Erwin
authors.initials: E
authors.lastname: Ströker
authors.affiliation: Mercy General Hospital and Dignity Health Heart and Vascular Institute, 3941 J St, Suite #350, Sacramento, California.
authors.forename: Arash
authors.initials: A
authors.lastname: Aryana
authors.affiliation: Electrophysiology Unit, Villa Maria Cecilia, Via Corriera, 1, 48033 Cotignola RA, Italy.
authors.forename: Saverio
authors.initials: S
authors.lastname: Iacopino
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Diego
authors.initials: D
authors.lastname: Ruggiero
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Hugo Enrique
authors.initials: HE
authors.lastname: Coutiño-Moreno
authors.forename: Rajin
authors.initials: R
authors.lastname: Choudhury
authors.forename: Juan-Pablo
authors.initials: JP
authors.lastname: Abugattas
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Ebru
authors.initials: E
authors.lastname: Hacioglu
authors.affiliation: Cliniques de L'Europe St Elizabeth, De Frélaan 206, 1180 Ukkel, Brussel, Belgium.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Paparella
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
mesh_terms: D000328:Adult; D000367:Age Factors; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D062906:Cardiac Catheters; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation*; D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Ablation; Atrial fibrillation; Cryoballoon; Pulmonary vein isolation; Recurrence; Young patients