One-year clinical success of a ‘no-bonus’ freeze protocol using the second-generation 28 mm cryoballoon for pulmonary vein isolation

• DOI: 10.1093/europace/euv024
• Publication Date: 2015-04-14T00:21:35Z
• Authors: Erik Wissner; Christian-Hendrik...; Hanno Grahn; Bruno Reissmann; Peter Wohlmuth; Christine Lemes; Peter Rausch; Shibu Mathew; Andreas Rillig; Sebastian Deiss; Tillman Maurer; Tina Lin; Roland Richard Tilz; Feifan Ouyang; Karl-Heinz Kuck; Andreas Metzner
• Keywords: Isolation

Studies on the use of second-generation 28 mm cryoballoon (CB) for treatment atrial fibrillation (AF) have reported superior 1-year clinical outcome. Customarily, a bonus freeze cycle is applied after pulmonary vein isolation (PVI). The purpose present study was to assess outcome following PVI foregoing cycle. Patients with drug-refractory paroxysmal AF (PAF) or persistent underwent using CB. duration set at 240 s. No applied. Clinical follow-up (FU) included 12-lead ECGs and 24h-Holter 3, 6, 12 months. A total 45 patients (age 60 ± 11 years, mean LA diameter 42.1 8.6 mm, n = 38 [84%] PAF) CB-based PVI. Of 177 veins (PVs) identified, 176/177 (99%) PVs were successfully isolated. number CB applications 1.2 0.4, 1.5 0.8, 1.4 0.7, 1.1 0.3 1.7 right PVs, inferior left common respectively. Mean procedure fluoroscopy times 113 32 19 7 min, Phrenic nerve palsy occurred in 1/45 (2%) patients. One lost FU. After FU period 392 58 (267–522) days including 3-month blanking period, 36 44 (82%) remained stable sinus rhythm. Five out eight arrhythmia recurrence second procedure. Only those isolated single (5/11 45%) demonstrated PV reconduction. In contrast, no reconnection found initially treated multiple cycles. 'no-bonus'-freeze protocol resulted an 82% success rate. successful may not be essential