Acute outcome after a single cryoballoon ablation: Comparison between Arctic Front Advance and Arctic Front Advance PRO

• Published in: Pacing and Clinical Electrophysiology
• Main Authors: Moltrasio, Massimo, Sicuso, Rita, Fassini, Gaetano M, Riva, Stefania I, Tundo, Fabrizio, Dello Russo, Antonio, Casella, Michela, Majocchi, Benedetta, Zucchetti, Martina, Cellucci, Selene, Tondo, Claudio
• Other Authors: M. Moltrasio, R. Sicuso, G.M. Fassini, S.I. Riva, F. Tundo, A. Dello Russo, M. Casella, B. Majocchi, M. Zucchetti, S. Cellucci, C. Tondo
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2019
• Subjects: atrial fibrillation; catheter ablation; cryoablation; cryoballoon catheter; pulmonary vein isolation; Settore MED/11 - Malattie dell'Apparato Cardiovascolare; Arctic
• Online Access: http://hdl.handle.net/2434/643688; https://doi.org/10.1111/pace.13718

BACKGROUND: The novel fourth-generation cryoballoon (CB4) potentially allows for enhanced catheter maneuverability and more frequent capture of pulmonary vein (PV) potentials which can be used to monitor real-time PV isolation (PVI). The aim of our study is to compare the acute procedural endpoints between the CB4 and second-generation cryoballoon (CB2). METHODS: A single-center retrospective chart review was used to examine 50 consecutive patients with drug-refractory atrial fibrillation undergoing CB4-based PVI. Procedural data and acute success of these patients were compared to 50 propensity-matched controls who underwent cryoballoon ablation procedure using CB2. RESULTS: Procedures performed with the CB4 showed significant shorter fluoroscopy time (14.8 ± 5.5 vs 18.0 ± 6.5 minutes, P = .04), shorter procedure time (58.3 ± 15.7 vs 65.3 ± 21 minutes, P = .13), and shorter total ablation time (10.8 ± 1.5 vs 13.8 ± 1.9 minutes, P = .42). The real-time PVI visualization rate was 33.3% in the CB2 group and 74.7% in the CB4 group (P < .001). CB4 was correlated to significant increase of acute real-time recordings with regard to all the single PV (left superior PV: 58% vs 84%, P = .02; left inferior PV: 26% vs 71%, P = .001; right superior PV 29% vs 61%, P = .01; and right inferior PV 19% vs 58%, P = .002). CONCLUSION: The CB4 was more often able to capture real-time recordings of PV potentials and the subsequent acute PV isolation.