Towards a tailored cryo-pulmonary vein isolation. Lessons learned from second-generation cryoballoon ablation

Second–generation cryoballoon ablation has emerged as an effective and practical approach for the treatment of atrial fibrillation. It gained the overall interest of the electrophysiology community due to its excellent success rates, and reproducible clinical outcomes comparable to the point-by-poin...

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Published inTrends in cardiovascular medicine Vol. 29; no. 7; pp. 420 - 425
Main Authors Ciconte, Giuseppe, Coulombe, Nicolas, Brugada, Pedro, de Asmundis, Carlo, Chierchia, Gian-Battista
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.10.2019
Elsevier Limited
Subjects
Ablation
Action Potentials
Atrial fibrillation
Atrial Fibrillation - diagnosis
Atrial Fibrillation - physiopathology
Atrial Fibrillation - surgery
Cardiac arrhythmia
Catheters
Cooling
Cryoballoon
Cryosurgery - adverse effects
Cryosurgery - instrumentation
Electrophysiology
Fibrillation
Freeze duration
Freeze-thawing
Heart Rate
Humans
Laboratories
Pulmonary vein isolation
Pulmonary Veins - physiopathology
Pulmonary Veins - surgery
PV reconnection
Radiofrequency ablation
Recurrence
Risk Factors
Treatment Outcome
Veins & arteries
United States > US
Arctic region
PV reconnection
Cryoballoon
Ablation
Atrial fibrillation
Freeze duration
Pulmonary vein isolation
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Summary:Second–generation cryoballoon ablation has emerged as an effective and practical approach for the treatment of atrial fibrillation. It gained the overall interest of the electrophysiology community due to its excellent success rates, and reproducible clinical outcomes comparable to the point-by-point radiofrequency technique. This technology offers several advantages including a fast learning curve and shorter procedure times making this device widely adopted in many EP-laboratories as an alternative strategy to conventional point-by-point radiofrequency ablation. As compared to its predecessor, the improved technical performances of the second-generation cryoballoon translated into favorable clinical outcomes, which are maintained in long-term follow-up. However, the ideal cryo-application duration and the adequate number of freeze-thaw cycles are not well established and predictors of durable electrical isolation are poorly known. This review provides some practical advices for a successful ablation using the second-generation cryoballoon.
Bibliography:ObjectType-Article-2
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ISSN:1050-1738
1873-2615
DOI:10.1016/j.tcm.2018.11.009