Single freeze strategy with the second-generation cryballoon for atrial fibrillation: a multicenter international retrospective analysis in a large cohort of patients

• Main Authors: De Regibus, Valentina, Iacopino, Saverio, Abugattas, Juan Pablo, Coutiño, Hugo Enrique, Mugnai, Giacomo, Storti, Cesare, Conte, Giulio, Auricchio, Angelo, Moran, Darragh, Ströker, Erwin, Marroquin, Luis, Takarada, Ken, Choudhury, Rajin, de Asmundis, Carlo, Brugada, Pedro, Chierchia, Gian-Battista
• Format: Article in Journal/Newspaper
• Language: English
• Published: Springer 2017
• Subjects: Cardiocentro Ticino; 610 Medicine & health; Arctic
• Online Access: https://www.zora.uzh.ch/id/eprint/145479/; https://www.zora.uzh.ch/id/eprint/145479/1/6._10.1007-s10840-017-0254-6-2.pdf; https://doi.org/10.5167/uzh-145479; https://doi.org/10.1007/s10840-017-0254-6

PURPOSE: The second-generation cryoballoon (CB-A, Arctic Front Advance, Medtronic, Minneapolis, MN, USA) has proven to be highly effective in achieving freedom from atrial fibrillation; nonetheless, the ideal number and duration of freezing cycles is still a matter of debate. We investigated the acute success, procedural complications, and clinical outcome of a single freeze strategy using the CB-A in a large, retrospective, international multicenter study. METHODS: Between January 2013 and September 2015, 818 consecutive patients (58 ± 12 years, 68% males) with drug-resistant atrial fibrillation (AF) who underwent a CB-A using a single freeze strategy were taken into consideration for our analysis. RESULTS: Paroxysmal AF was documented in 74.1% of the patients, while 25.9% presented with persistent AF. Additional freezes were needed in a mean 1.4 veins per patient. 0.2% of the patients experienced persistent PNP that was still documented at the last follow-up. After a median follow-up of 14 ± 8 months, taking into consideration a blanking period (BP) of 3 months, 692 patients (84.6%) were free from arrhythmia recurrence. After a single procedure, AF recurrence during BP and persistent AF were identified as predictors of clinical recurrence after BP. CONCLUSIONS: Single freeze CB-A ablation is effective in treating drug-resistant AF and affords freedom from arrhythmia recurrences in 84.6% of patients during a 14-month follow-up. Persistent AF and recurrence during BP are predictors of arrhythmia recurrences.