Abstract | 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: 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.
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Authors | Giuseppe Ciconte, Carlo de Asmundis, Juan Sieira, Giulio Conte, Giacomo Di Giovanni, Giacomo Mugnai, Yukio Saitoh, Giannis Baltogiannis, Ghazala Irfan, Hugo Enrique Coutiño-Moreno, Burak Hunuk, Vedran Velagić, Pedro Brugada, Gian-Battista Chierchia |
Journal | Heart rhythm
(Heart Rhythm)
Vol. 12
Issue 4
Pg. 673-80
(Apr 2015)
ISSN: 1556-3871 [Electronic] United States |
PMID | 25542427
(Publication Type: Journal Article)
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Copyright | Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. |
Topics |
- Aged
- Atrial Fibrillation
(diagnosis, surgery)
- Catheter Ablation
(instrumentation)
- Cryosurgery
(instrumentation)
- Electrocardiography
- Equipment Design
- Female
- Follow-Up Studies
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Postoperative Complications
(diagnosis, surgery)
- Pulmonary Veins
(surgery)
- Recurrence
- Reoperation
- Time Factors
- Treatment Outcome
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