Conclusion In patients with paroxysmal atrial fibrillation  , cryoballoon and radiofrequency ablation produce similar results in terms of freedom from recurrent atrial fibrillation or atrial tachyarrhythmias but with a different safety profile , being cryoballoon ablation less associated with cardiac complications but more likely to cause phrenic nerve palsy
Aims To perform an up date d meta- analysis to assess efficacy , safety and technical performance of pulmonary vein isolation using cryoballoon or radiofrequency catheter ablation in patients with paroxysmal or persistent atrial fibrillation .
Real-time assessment of pulmonary vein disconnection during cryoablation of atrial fibrillation: can it be 'achieved' in almost all cases?
AIM Real-time assessment of pulmonary vein ( PV ) disconnection is possible using an inner circular mapping catheter during cryoablation of atrial fibrillation ( AF ) . However , it has been recently demonstrated that such continuous monitoring may only be possible in < 50 % of PVs . We hypothesized that a stepwise mapping approach , including pacing manoeuvres , could optimize monitoring of real-time PV disconnection during ablation . METHODS AND RESULTS Single-centre , prospect i ve observational study ( NCT01843465 ) including 34 consecutive eligible patients ( 128 PVs ) undergoing a first procedure of cryoballoon ablation of AF using the Artic Front Advance ( ® ) 28 mm catheter and a 20 mm diameter Achieve ( ® ) catheter ( AC )  in all cases . Monitoring of real-time entrance block was possible , when AC was maintained in the st and ard position ( distal to the tip of the Artic Front Advance ( ® ) catheter ) in 47 ( 36.7 % ) PVs . In an additional 63 cases ( 49.2 % ) , such monitoring was possible after moving AC to a more proximal position and using different torqueing movements . Finally , using supplemental systematic pacing manoeuvres to test exit block , real-time assessment of PV disconnection was possible in 15 ( 11.7 % ) more PVs . Overall , real-time assessment of PV disconnection was possible in 97.7 % of cases , after a mean duration of 48.6 ± 33.0 s. CONCLUSION Our results suggest that optimal use of the AC , with a systematic stepwise mapping approach , may dramatically improve the real-time monitoring of PV disconnection during AF cryoablation
Conclusion In patients with paroxysmal atrial fibrillation  , cryoballoon and radiofrequency ablation produce similar results in terms of freedom from recurrent atrial fibrillation or atrial tachyarrhythmias but with a different safety profile , being cryoballoon ablation less associated with cardiac complications but more likely to cause phrenic nerve palsy
Aims To perform an up date d meta- analysis to assess efficacy , safety and technical performance of pulmonary vein isolation using cryoballoon or radiofrequency catheter ablation in patients with paroxysmal or persistent atrial fibrillation .