Publication

Cryoballoon ablation for pulmonary vein isolation in patients with paroxysmal atrial fibrillation

Journal Paper/Review - Apr 17, 2010

Units
PubMed
Doi

Citation
Kühne M, Schaer B, Ammann P, Suter Y, Osswald S, Sticherling C. Cryoballoon ablation for pulmonary vein isolation in patients with paroxysmal atrial fibrillation. Swiss Med Wkly 2010; 140:214-21.
Type
Journal Paper/Review (English)
Journal
Swiss Med Wkly 2010; 140
Publication Date
Apr 17, 2010
Issn Electronic
1424-3997
Pages
214-21
Brief description/objective

Cryoballoon ablation has emerged as a novel treatment option for drug-refractory atrial fibrillation (AF). The purpose of this manuscript is to report the initial experience of a Swiss centre performing cryoballoon ablation, and to provide a critical review of the literature. Fourteen patients (age 59 +/- 10 years, LVEF 57 +/- 5%, left atrial size 41 +/- 3 mm) with paroxysmal AF were studied. After transseptal puncture, a 28 mm cryoballoon catheter was inserted into the left atrium. After balloon positioning at the antrum of each pulmonary vein (PV), cryoballoon ablation was performed (5 minutes/application). The endpoint of the ablation was pulmonary vein isolation (PVI). Eighty-four percent of all PVs could be isolated with the cryoballoon alone. There was no specific distribution of the PVs requiring additional non-balloon ablation. The mean procedure time was 199 +/- 56 minutes. One patient developed tamponade requiring drainage. No phrenic nerve palsies occurred. After a period of follow-up of 12 +/- 3 months, 10/14 patients (71%) were in sinus rhythm without antiarrhythmic drugs. A review of AF ablation procedures performed at our centre during a one-year period showed that documentation of persistent AF or other arrhythmias were the causes for not using the cryoballoon in 49% of patients because additional linear lesions may be required in these cases. Cryoballoon ablation is an interesting new tool for PVI. The success rate of 71% after a 1-year follow-up is not higher when compared to radiofrequency ablation. Furthermore, data on long-term outcomes are lacking. Randomised comparisons with radiofrequency catheter ablation are needed.