Purpose. The results of cryoballoon ablation (CBA) procedure have been mainly derived from studies conducted in experienced atrial fibrillation (AF) ablation centres. Here, we report on CBA efficacy and complications resulting from real practice of this procedure at both high- and low-volume centres. Methods. Among 62 Russian centres performing AF ablation, 15 (24%) used CBA technology for pulmonary vein isolation. The centres were asked to provide a detailed description of all CBA procedures performed and complications, if encountered. Results. Thirteen sites completed interviews on all CBAs in their centres (>95% of CBAs in Russia). Six sites were high-volume AF ablation (>100 AF cases/year) centres, and 7 were low-volume AF ablation. There was no statistical difference in arrhythmia-free rates between high- and low-volume centres (64.6 versus 60.8% at 6 months). Major complications developed in 1.5% of patients and were equally distributed between high- and low-volume centres. Minor procedure-related events were encountered in 8% of patients and were more prevalent in high-volume centres. Total event and vascular access site event rates were higher in women than in men. Conclusions. CBA has an acceptable efficacy profile in real practice. In less experienced AF ablation centres, the major complication rate is equal to that in high-volume centres.

The article discusses the issues concerning the treatment of patients with the atrial fibrillation (AF), analyzes the indications for execution, in the absence of the effect of medication treatment, radiofrequency catheter ablation (RFA) of the lung vein entries and electrical spiral waves in the atria or rotors, the clinical effects of this procedure, assesses the contribution of focal activity in maintaining the persistent AF. The influence of concomitant pathology and anatomical-morphological peculiarities of the heart on early and distant RFA results in patients with persistent AF is discussed. The success and efficacy of AF surgical treatment depends not only on the method and technology of the chosen procedure, but also on the risk factors for the recurrence of AF (so-called predictors). Radio-frequency ablation, being an invasive surgery, has its own spectrum of possible complications and high economic component, which predetermines the necessity to predict the efficiency of the procedure, i.e. preoperative determination of the patient group, in which this type of treatment will be justified, and the expected efficiency and safety – higher than the probability of complications. The study of this problem and the development of criteria for selecting patients with AF will allow predicting the effectiveness of surgical intervention with high probability, which in turn will contribute to the correct strategy selection.