BACKGROUND: The second-generation cryoballoon delivers effective pulmonary vein isolation (PVI) associated with superior 1-year clinical outcome. However, data on reconduction of previously isolated PV are sparse. METHODS AND RESULTS: A total of 421 patients underwent second-generation 28-mm cryoballoon-based PVI in 2 centers (St. George's hospital and Harburg hospital, Hamburg, Germany) between June 2012 and May 2015. Sixty-six of 421 (16%) patients (39/66, 59% women; mean age, 63±10 years, mean left atrium diameter, 45±6 mm) with a history of paroxysmal (40/66, 61%) or persistent atrial fibrillation and atrial tachyarrhythmia recurrences despite previous successful second-generation 28-mm cryoballoon-based PVI were included in this analysis. During the index PVI, the standard freeze cycle duration was 240 s. After successful PVI, a bonus freeze cycle of 240 s was applied in the first 15 of 66 (23%) patients, whereas no bonus freeze cycle was applied in the remaining patients. Repeat procedures were performed after a median of 205 (131-357) days following the index ablation. Electric reconduction was assessed for all PVs, and reablation was performed using radiofrequency energy. Persistent electric isolation was noted in 178 of 258 (69%) PVs. In 17 of 66 (26%) patients, all previously targeted PVs remained isolated. A significant difference toward highest reconduction rate for the posteroinferior segment of the right inferior PV was found (P=0.0002). CONCLUSIONS: The second-generation cryoballoon ablation is associated with a high rate of persistent PVI. The posteroinferior segment of the right inferior PV showed the highest reconduction rate and seems to be a predilection site for PV reconduction.
BACKGROUND: The second-generation cryoballoon delivers effective pulmonary vein isolation (PVI) associated with superior 1-year clinical outcome. However, data on reconduction of previously isolated PV are sparse. METHODS AND RESULTS: A total of 421 patients underwent second-generation 28-mm cryoballoon-based PVI in 2 centers (St. George's hospital and Harburg hospital, Hamburg, Germany) between June 2012 and May 2015. Sixty-six of 421 (16%) patients (39/66, 59% women; mean age, 63±10 years, mean left atrium diameter, 45±6 mm) with a history of paroxysmal (40/66, 61%) or persistent atrial fibrillation and atrial tachyarrhythmia recurrences despite previous successful second-generation 28-mm cryoballoon-based PVI were included in this analysis. During the index PVI, the standard freeze cycle duration was 240 s. After successful PVI, a bonus freeze cycle of 240 s was applied in the first 15 of 66 (23%) patients, whereas no bonus freeze cycle was applied in the remaining patients. Repeat procedures were performed after a median of 205 (131-357) days following the index ablation. Electric reconduction was assessed for all PVs, and reablation was performed using radiofrequency energy. Persistent electric isolation was noted in 178 of 258 (69%) PVs. In 17 of 66 (26%) patients, all previously targeted PVs remained isolated. A significant difference toward highest reconduction rate for the posteroinferior segment of the right inferior PV was found (P=0.0002). CONCLUSIONS: The second-generation cryoballoon ablation is associated with a high rate of persistent PVI. The posteroinferior segment of the right inferior PV showed the highest reconduction rate and seems to be a predilection site for PV reconduction.
Authors: Gaetano Paparella; Saverio Iacopino; Thiago Guimarães Osório; Juan Pablo Abugattas de Torres; Erwin Ströker; Juan Sieira; Hannes Vanacker; Bernard De Ruyter; Serge Boveda; Riccardo Maj; Gianluca Borio; Alessandro Rizzo; Alessio Galli; Pedro Brugada; Carlo de Asmundis; Gian-Battista Chierchia Journal: J Interv Card Electrophysiol Date: 2020-05-31 Impact factor: 1.900
Authors: Arash Aryana; Sheldon M Singh; Giacomo Mugnai; Carlo de Asmundis; Marcin Kowalski; Deep K Pujara; Andrew I Cohen; Steve K Singh; Charles E Fuenzalida; Nelson Prager; Mark R Bowers; Padraig Gearoid O'Neill; Pedro Brugada; André d'Avila; Gian-Battista Chierchia Journal: J Interv Card Electrophysiol Date: 2016-07-30 Impact factor: 1.900
Authors: Bruno Reissmann; Thorsten Budelmann; Erik Wissner; Michael Schlüter; Christian-Hendrik Heeger; Shibu Mathew; Tilman Maurer; Christine Lemes; Thomas Fink; Andreas Rillig; Francesco Santoro; Johannes Riedl; Feifan Ouyang; Karl-Heinz Kuck; Andreas Metzner Journal: Clin Res Cardiol Date: 2017-12-28 Impact factor: 5.460
Authors: Christian-H Heeger; Erik Wissner; Shibu Mathew; Kentaro Hayashi; Christian Sohns; Bruno Reißmann; Christine Lemes; Tilmann Maurer; Thomas Fink; Ardan M Saguner; Francesco Santoro; Johannes Riedl; Feifan Ouyang; Karl-Heinz Kuck; Andreas Metzner Journal: Clin Res Cardiol Date: 2015-11-25 Impact factor: 5.460