Adverse events in cryoballoon ablation for pulmonary vein isolation: Insight from the Food and Drug Administration Manufacturer and User Facility Device Experience

• Published in: Journal of Arrhythmia
• Main Authors: Min Choon Tan, Jian Liang Tan, Wei Jun Lee, Komandoor Srivathsan, Dan Sorajja, Hicham El Masry, Luis R. Scott, Justin Z. Lee
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2023
• Subjects: adverse events; atrial fibrillation; cryoballoon ablation; outcome assessment; pulmonary vein isolation; Diseases of the circulatory (Cardiovascular) system; RC666-701; Arctic
• Online Access: https://doi.org/10.1002/joa3.12898; https://doaj.org/article/9ab3c6d6c3d14f348a694c99267844c7

Abstract Background Real‐world clinical data on the adverse events related to the use of cryoballoon catheter for pulmonary vein isolation remains limited. Objective To report and describe the adverse events related to the use of Artic Front cryoballoon catheters (Arctic Front, Arctic Front Advance, and Arctic Front Advance Pro) reported in the Food and Drug Administration's (FDA) Manufacturers and User Defined Experience (MAUDE) database. Methods We reviewed all the adverse events reported to the FDA MAUDE database over a 10.7‐year study period from January 01, 2011 to September 31, 2021. All events were independently reviewed by two physicians. Results During the study period, a total of 320 procedural‐related adverse events reported in the MAUDE database were identified. The most common adverse event was transient or persistent phrenic nerve palsy (PNP), accounting for 48% of all events. This was followed by cardiac perforation (15%), pulmonary vein stenosis (8%), transient ischemic attack or stroke (6%), vascular injury (4%), transient or persistent ST‐elevation myocardial infarction (3%), hemoptysis (2%), pericarditis (2%), and esophageal ulcer or fistula (1%). There were six reported intra‐procedural death events as a result of cardiac perforation. Conclusion The two most common procedural adverse events associated with cryoballoon ablation were PNP and cardiac perforation. All cases of procedural mortality were due to cardiac perforation.