BACKGROUND: The second-generation cryoballoon (CB-Adv) is effective in achieving pulmonary vein isolation (PVI) with encouraging results. The mid-term clinical efficacy of a single 3-minute freeze, without a routine bonus application, has been recently demonstrated. OBJECTIVE: The purpose of this study was to assess long-term clinical outcome after PVI with the CB-Adv using a single 3-minute application. METHODS: A total of 143 consecutive patients (93 male [65%], mean age 59.6 ± 12.0 years) with paroxysmal atrial fibrillation (PAF; 113/143 [79%]) or early persistent atrial fibrillation (AF; 30/143 [21%]) underwent PVI using CB-Adv with a single 3-minute freeze. Atrial tachyarrhythmia recurrences were defined as symptomatic or documented episodes >30 seconds. RESULTS: After a single freeze, isolation could be reached in 94.1% of all identified pulmonary veins. Complete PVI was successfully achieved with 1.1 ± 0.4 mean freezes. Persistent phrenic nerve palsy occurred in 5 of 143 patients (3.5%). At a mean 12.1 ± 4.4 months of follow-up, after a 3-month blanking period (BP), 80.4% (115/143) were in stable sinus rhythm (93/113 [82.3%] for PAF; 22/30 [73.3%] for early persistent AF). Fifteen patients underwent a second procedure with radiofrequency ablation showing reconnection in 7 of 15 right-sided (46.7%) and 6 of 15 left-sided (40%) pulmonary veins. Relapses during BP (P <.01), time to PVI (P = .02), and longer AF duration (P = .04) were independent predictors of recurrences. CONCLUSION: A single 3-minute freeze is highly effective, determining an atrial tachyarrhythmia freedom of 80.4% at 1-year follow-up. The incidence of persistent phrenic nerve palsy is 3.5%. Relapses during BP, time to PVI, and longer AF duration are predictors of recurrences. Routine use of an "insurance freeze" may not be needed.
BACKGROUND: The second-generation cryoballoon (CB-Adv) is effective in achieving pulmonary vein isolation (PVI) with encouraging results. The mid-term clinical efficacy of a single 3-minute freeze, without a routine bonus application, has been recently demonstrated. OBJECTIVE: The purpose of this study was to assess long-term clinical outcome after PVI with the CB-Adv using a single 3-minute application. METHODS: A total of 143 consecutive patients (93 male [65%], mean age 59.6 ± 12.0 years) with paroxysmal atrial fibrillation (PAF; 113/143 [79%]) or early persistent atrial fibrillation (AF; 30/143 [21%]) underwent PVI using CB-Adv with a single 3-minute freeze. Atrial tachyarrhythmia recurrences were defined as symptomatic or documented episodes >30 seconds. RESULTS: After a single freeze, isolation could be reached in 94.1% of all identified pulmonary veins. Complete PVI was successfully achieved with 1.1 ± 0.4 mean freezes. Persistent phrenic nerve palsy occurred in 5 of 143 patients (3.5%). At a mean 12.1 ± 4.4 months of follow-up, after a 3-month blanking period (BP), 80.4% (115/143) were in stable sinus rhythm (93/113 [82.3%] for PAF; 22/30 [73.3%] for early persistent AF). Fifteen patients underwent a second procedure with radiofrequency ablation showing reconnection in 7 of 15 right-sided (46.7%) and 6 of 15 left-sided (40%) pulmonary veins. Relapses during BP (P <.01), time to PVI (P = .02), and longer AF duration (P = .04) were independent predictors of recurrences. CONCLUSION: A single 3-minute freeze is highly effective, determining an atrial tachyarrhythmia freedom of 80.4% at 1-year follow-up. The incidence of persistent phrenic nerve palsy is 3.5%. Relapses during BP, time to PVI, and longer AF duration are predictors of recurrences. Routine use of an "insurance freeze" may not be needed.
Authors: Giacomo Mugnai; Carlo de Asmundis; Burak Hünük; Erwin Ströker; Darragh Moran; Ebru Hacioglu; Diego Ruggiero; Jan Poelaert; Christian Verborgh; Vincent Umbrain; Stefan Beckers; Hugo Enrique Coutino-Moreno; Ken Takarada; Valentina de Regibus; Pedro Brugada; Gian-Battista Chierchia Journal: J Interv Card Electrophysiol Date: 2016-02-12 Impact factor: 1.900
Authors: Valter Giaretto; Andrea Ballatore; Claudio Passerone; Paolo Desalvo; Mario Matta; Andrea Saglietto; Mario De Salve; Fiorenzo Gaita; Bruno Panella; Matteo Anselmino Journal: J R Soc Interface Date: 2019-09-18 Impact factor: 4.118
Authors: Buelent Koektuerk; Hikmet Yorgun; Oezlem Koektuerk; Cem H Turan; Muhammet Necati Murat Aksoy; Ramazan G Turan; Eduard Gorr; Paul M Bansmann; Christian Hoppe; Marc Horlitz Journal: J Interv Card Electrophysiol Date: 2016-05-17 Impact factor: 1.900
Authors: Saverio Iacopino; Gaetano Paparella; Lucio Capulzini; Erwin Ströker; Stefan Beckers; Thiago Guimarães Osório; Varnavas Varnavas; Juan Sieira; Juan Pablo Abugattas; Riccardo Maj; Francesca Salghetti; Vincent Umbrain; Muryo Terasawa; Pedro Brugada; Carlo de Asmundis; Gian Battista Chierchia Journal: J Interv Card Electrophysiol Date: 2019-04-27 Impact factor: 1.900
Authors: Hugo Enrique Coutiño; Carlo de Asmundis; Giacomo Mugnai; Darragh Moran; Valentina De Regibus; Erwin Ströker; Ken Takarada; Diego Ruggiero; Rajin Choudhury; Stefan Beckers; Carla Van Gompel; Jan Poelaert; Saverio Iacopino; Pasquale Filannino; Pedro Brugada; Gian-Battista Chierchia Journal: J Interv Card Electrophysiol Date: 2016-08-25 Impact factor: 1.900