Bonus-freeze: benefit or risk? Two-year outcome and procedural comparison of a “bonus-freeze” and “no bonus-freeze” protocol using the second-generation cryoballoon for pulmonary vein isolation

Male Time Factors Time Factor 610 Medicine & health Cryoballoon Radiation Dosage Radiography, Interventional Pulmonary vein isolation Cryosurgery Risk Assessment 2705 Cardiology and Cardiovascular Medicine Cardiac Catheters Electrocardiography 03 medical and health sciences 0302 clinical medicine Retrospective Studie Risk Factors Ambulatory Atrial Fibrillation Humans Long-term follow-up Aged Retrospective Studies Original Paper Interventional Cardiac Catheter Risk Factor Pulmonary Vein General Medicine Equipment Design Middle Aged Radiation Exposure Atrial fibrillation 3. Good health Radiography Treatment Outcome Pulmonary Veins Fluoroscopy 10209 Clinic for Cardiology Electrocardiography, Ambulatory Female Cardiology and Cardiovascular Medicine Human
DOI: 10.1007/s00392-016-0987-8 Publication Date: 2016-04-16T08:22:01Z
ABSTRACT
Second-generation cryoballoon based pulmonary vein isolation has demonstrated encouraging acute and mid-term clinical outcome. Customarily, a bonus-freeze is applied after successful pulmonary vein isolation.To compare the long-term clinical outcome and safety profile of a bonus-freeze and a no bonus-freeze protocol.A total of 120 consecutive patients with paroxysmal [95/120 (79 %)] or persistent atrial fibrillation [25/120 (21 %)] underwent CB2-based PVI. Freeze-cycle duration was 240 s. In the first 60 patients a bonus-freeze was applied after successful PVI (group 1), while in the following 60 patients the bonus-freeze was omitted (group 2).Procedure and fluoroscopy times were significantly shorter in group 2 [113.8 ± 32 vs 138.2 ± 29 min (p = 0.03) and 19.2 ± 6 vs 24.3 ± 8 min (p = 0.02)]. No differences in procedural complications were found. During a mean follow-up of 849 ± 74 (group 1) and 848 ± 101 days (group 2, p = 0.13) 69 % of patients (group 1) and 67 % of patients (group 2) remained in stable sinus rhythm without any differences between the groups (p = 0.69).Freedom from atrial fibrillation after second-generation cryoballoon based pulmonary vein isolation and a follow-up of >2 years is comparable when applying a bonus- and a no bonus-freeze protocol, while procedure and fluoroscopy times are significantly shorter when omitting the bonus-freeze. No differences in periprocedural complications were identified.
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