No death or myocardial infa rct ion was reported .
CONCLUSION ' PVI-plus ' involving 2G-CB seems to be safe and effective for treating PerAF
BACKGROUND Growing evidence suggests that second-generation cryoballoon ablation ( 2G-CB ) is effective in patients with persistent atrial fibrillation ( PerAF ) .
The cornerstone of atrial fibrillation ( AF ) ablation is pulmonary vein isolation ( PVI ) .
The purpose of this study was to summarize the available data on the safety and mid-term ( ≥ 12 months ) effectiveness of a ' PVI-only ' strategy vs. a ' PVI-plus ' strategy using 2G-CB in patients with PerAF .
Differences of two cryoballoon generations: insights from the prospective multicentre, multinational FREEZE Cohort Substudy.
AIMS Cryoballoon ( CB ) ablation with the second-generation cryoballoon ( CBG2 ) seems to be more effective than its predecessor [ first-generation cryoballoon ( CBG1 ) ] , but phrenic nerve palsies were observed more frequently . The aim of this study was to compare the safety and efficacy of CBG1 and CBG2 in a sub study of the prospect i ve multicentre , multinational FREEZE Cohort Study . METHODS AND RESULTS Periprocedural data were analysed , and a total of 532 patients with paroxysmal atrial fibrillation ( AF ) were examined ( n = 224 for CBG1 and n = 308 for CBG2 ) . Procedure time decreased significantly from 149 to 130 min when comparing CBG1 with CBG2 ( P < 0.0001 ) , and pulmonary vein isolation ( PVI ) was achieved in 97.8 and 97.6 % of PVs with CBG1 and CBG2 ( P = 0.77 ) , respectively . The need for dual-balloon usage within a procedure dropped ( 20.1 vs. 9.0 % , P < 0.001 ) , and the fluoroscopy time was reduced when operating the CBG2 .  Atrial fibrillation recurrence rates until discharge were similar ( 5.0 vs. 5.8 % , P = 0.69 ) . Comparable low rates of major complications were observed with both CBs , and there was a non-significant trend for more phrenic nerve palsies . CONCLUSION Second-generation cryoballoon demonstrated a high rate of acute PVI in a significant faster procedure , which also utilized less radiation exposure and less dual-balloon usage during an average procedure . The safety profile remains favourable with a non-significant trend for more phrenic nerve palsies . If the enhancements lead to a higher clinical benefit has to be determined . The 1-year outcome data from the ongoing FREEZE Cohort Study comparing radiofrequency and CB ablation will shed some light on that issue . CLINICAL TRIALS GOV IDENTIFIER NCT01360008
No death or myocardial infa rct ion was reported .
CONCLUSION ' PVI-plus ' involving 2G-CB seems to be safe and effective for treating PerAF
BACKGROUND Growing evidence suggests that second-generation cryoballoon ablation ( 2G-CB ) is effective in patients with persistent atrial fibrillation ( PerAF ) .
The cornerstone of atrial fibrillation ( AF ) ablation is pulmonary vein isolation ( PVI ) .
The purpose of this study was to summarize the available data on the safety and mid-term ( ≥ 12 months ) effectiveness of a ' PVI-only ' strategy vs. a ' PVI-plus ' strategy using 2G-CB in patients with PerAF .