Abstract 15020: Ablation of Paroxysmal Atrial Fibrillation Applying an Improved Cryoballoon: is Reduction of Freezing Time Possible?

• Published in: Circulation
• Main Authors: Nölker, Georg, Molatta, Stephan, Koch, Frauke, Hossain, M. Sajid, Bullert, Kevin, Horstkotte, Dieter, Gutleben, Klaus-Jürgen
• Format: Article in Journal/Newspaper
• Language: English
• Published: Ovid Technologies (Wolters Kluwer Health) 2014
• Subjects: Physiology (medical); Cardiology and Cardiovascular Medicine; Arctic
• Online Access: http://dx.doi.org/10.1161/circ.130.suppl_2.15020

Introduction: Cryoballoon (CB) ablation has been adopted by many centers worldwide for treatment of atrial fibrillation (AF). An improved version of the CB providing homogeneous cooling at its total frontal side has been introduced (Arctic Front Advance™, Medtronic). Hypothesis: We aimed to evaluate whether reduction of cooling times in application of this advanced CB is possible without affecting the outcome. Methods: A total of 94 patients (pts) (44 male, 58 ± 13 years) suffering from paroxysmal AF were prospectively assigned to CB pulmonary vein isolation choosing either 2 x 4 minutes (group 1) or 2 x 3 minutes (group 2) of freezing per vein. In case of pull-down maneuvers 120 s application time at the superior edge was followed by additional freezing of 3 or 4 minutes respectively after pull-down. Follow-up at 3, 6 months completed in all pts. included a clinical visit and a 7-day Holter or a readout of an implanted device for evaluation of AF burden. Results: Groups were well balanced in terms of left atrial size, left ventricular function, concomitant diseases and duration of AF. Total procedure time was reduced from 116±28 to 109±23 minutes (p=n.s.). Freezing time per pt decreased from 38.7±8.2 to 31.2±6.9 minutes (p<0.00001). Fluoroscopy time was similar between the groups (10.3±5.8; 12.1±5.5 min.; p=n.s.). During a follow-up of 6.4±1.8 months recurrence of AF was observed in 11 % of pts in group 1 versus 29 % of pts in group 2 (p=0.04). No major complications occurred in either group. Conclusions: Based on our preliminary findings, reduction of freezing time in CB ablation applying the improved version of the CB catheter seems to increase recurrence of AF. Therefore, it might be advisable to maintain longer freezing times. A prolonged follow-up will be available and presented at the meeting.