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 .
Incidence and characteristics of phrenic nerve palsy following pulmonary vein isolation with the second-generation as compared with the first-generation cryoballoon in 360 consecutive patients.
AIMS The second-generation cryoballoon ( CB2 ) with increased surface cooling has recently become available . The aim was to investigate the incidence and characteristics of phrenic nerve palsy ( PNP ) during pulmonary vein isolation ( PVI ) using the CB2 as compared with the first-generation balloon ( CB1 ) . METHODS AND RESULTS A total of 360 consecutive patients with atrial fibrillation underwent PVI with the CB1 ( 106 patients ) or the CB2 ( 254 patients ) .  Right PN function was monitored by continuous stimulation and palpation during septal PV ablation . Persistent PNP ( present at discharge ) occurred in 2.8 and 1.9 % ( P = 0.63 ) of patients , transient PNP ( full recovery before discharge ) in 5.9 and 3.8 % ( P = 0.41 ) of patients in the CB2 and CB1 group , respectively . Phrenic nerve palsy during ablation at the right inferior PV was observed in 0 % ( CB1 ) and 4.3 % ( CB2 , P = 0.03 ) of patients . Using the CB2 , a trend of reduced incidence of persistent PNP over quartiles of consecutive patients was observed [ 4.8 % ( Q1 ) vs. 0 % ( Q4 ) ; P = 0.077 ] . At the culprit PV , PNP occurred after 3.5 ± 2.1 ( CB1 ) and 1.1 ± 0.4 applications ( CB2 ; P = 0.036 ) . Complete recovery of PN function occurred after 29 ± 11 ( CB1 ) and 259 ± 137 days ( CB2 ; P = 0.004 ) . CONCLUSIONS The rate of transient/persistent PNP associated with the use of the CB2 was 5.9 and 2.8 % , respectively . Time to restitution of PN function was longer using the CB2
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 .