High incidence of focal and macro-reentrant arrythmias during repeat procedures after paroxysmal atrial fibrillation ablation using second-generation cryoballoon with no “bonus freeze” application

Abstract Background Little has been reported on the outcome of contact force (CF)-guided radiofrequency catheter ablation (RFCA) and second generation cryoballoon ablation (CBA). Purpose The purpose of this study was to compare the outcome of CF-guided RFCA and second generation CBA for paroxysmal atrial fibrillation (PAF). Methods We enrolled the consecutive 364 patients with PAF who underwent initial ablation between September 2014 and July 2018 in our hospital. We compared the late recurrence of atrial tachyarrhythmia more than three months after ablation between RFCA group and CBA group. All RFCA procedures were performed using CF-sensing catheter and all CBA procedures were performed using second generation CB. Results There were significant differences in background characteristics: chronic kidney disease, serum brain natriuretic peptide level, and left ventricular ejection fraction. After propensity score matched analysis (Table), atrial tachyarrhythmia free survival was significantly higher in CBA group than in RFCA group (Figure). Conclusions Second generation CBA showed a significantly lower late recurrence rate compared to CF-guided RFCA. Kaplan-Meier Curve Funding Acknowledgement Type of funding source: None

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Second-Generation Cryoballoon Ablation in the Setting of Lone Paroxysmal Atrial Fibrillation: Single Procedural Outcome at 12 Months

Journal of Cardiovascular Electrophysiology ◽

10.1111/jce.12973 ◽

2016 ◽

Vol 27 (6) ◽

pp. 677-682 ◽

Cited By ~ 7

Author(s):

VALENTINA DE REGIBUS ◽

GIACOMO MUGNAI ◽

DARRAGH MORAN ◽

BURAK HÜNÜK ◽

ERWIN STRÖKER ◽

...

Keyword(s):

Atrial Fibrillation ◽

Paroxysmal Atrial Fibrillation ◽

Second Generation ◽

Cryoballoon Ablation ◽

Procedural Outcome

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New cryoballoon atrial fibrillation ablation, is it the time for changes?

In a good rythm ◽

10.5604/01.3001.0012.0393 ◽

2018 ◽

Vol 2 (47) ◽

pp. 16-21

Author(s):

Grzegorz Hordyński ◽

Agnieszka Wojdyła-Hordyńska

Keyword(s):

Atrial Fibrillation ◽

Best Practice ◽

First Generation ◽

Second Generation ◽

Atrial Fibrillation Ablation ◽

Arctic Front ◽

Procedural Recommendations

Since the release of the second-generation cryoballoon (CB2; Arctic Front AdvanceTM, Medtronic Inc) and its modifications with improved cooling characteristics, the technique, dosing, and complication profile is significantly different from that of the first-generation cryoballoon. Several reports of CB2 procedural recommendations have been presented. Hereby, the literature summary was performed and the technical and procedural study based regimen delivered. The best practice overview presents large centers contemporary techniques for safer and more effective outcomes and perhaps new approved recommendations for atrial fibrillation treatment.

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