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 .
Phrenic nerve paralysis during cryoballoon ablation for atrial fibrillation: a comparison between the first- and second-generation balloon.
BACKGROUND Phrenic nerve palsy ( PNP ) is the most frequently observed complication during  cryoballoon ablation ( CB ; A rct ic Front , Medtronic , MN ) occurring in roughly 7%-9 % of the cases . The new second-generation cryoballoon ablation A rct ic Front Advance ( CB-A ) ( A rct ic Front ) has recently been launched in the market . OBJECTIVE To evaluate the incidence of right PNP with the new CB-A in comparison with the first-generation balloon in a series of consecutive patients that underwent pulmonary vein isolation with this modality . METHODS The study was design ed as an observational study with a prospect i ve follow-up . In total , 121 consecutive patients were included : 80 patients with the CB ( group 1 ) and 41 with the CB-A ( group 2 ) . RESULTS Mean procedural times , fluoroscopic times , and time to pulmonary vein isolation documented by real-time recordings were significantly lower in group 2 ( P ≤ .05 ) . The occurrence of PNP was significantly higher in group 2 ( 6.25 % [ 5 of 80 ] in group 1 vs 19.5 % [ 8 of 41 ] in group 2 ; P = .033 ) . At 7 months , PNP persisted in 1 ( 2.5 % ) patient in the CB-A group . CONCLUSIONS Right PNP seems to occur in a significantly larger number of patients with the second-generation CB-A. However , this complication is reversible in nearly all cases on short-term follow-up . More refined phrenic nerve monitoring during right-sided pulmonary vein ablation and less vigorous wedging maneuvers in the pulmonary vein ostia might significantly reduce the occurrence of this complication
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 .