Impact on Clinical Outcome of Premature Interruption of Cryoenergy Delivery Due to Phrenic Nerve Palsy During Second Generation Cryoballoon Ablation for Paroxysmal Atrial Fibrillation

Abstract

Conclusion: Our findings show that patients in whom freezing was interrupted due to PNP had a similar outcome on 1-year follow-up compared with those in whom freezing cycles were completed in the septal veins. No baseline clinical or procedural characteristics were found to predict AF recurrence in patients having experienced PNP.

One‐Year Clinical Outcome of Pulmonary Vein Isolation Using the Second‐Generation Cryoballoon: A Meta‐Analysis

“…There were five studies involving only paroxysmal AF patients, two studies involving only persistent AF patients, and eight studies involving both types of AF. As for ablation strategy, eight studies adopted the “bonus” strategy, two studies adopted the “no‐bonus” strategy, three studies adopted both strategies, and the remaining two studies did not provide sufficient information on their ablation strategies. Although several studies were carried out by the same authors' groups, we ruled out the possibility of patient groups duplication based on study methods and patient characteristics.…”

“…Nine studies reported the clinical success rates of patients with paroxysmal AF. PVI with CB‐2G resulted in a 1‐year clinical success rate of 82% (95% CI: 79–86%) in paroxysmal AF.…”

“…Five studies reported the 1‐year clinical success rates of the “no‐bonus” strategy. The pooled estimates showed that “no‐bonus” strategy achieved clinical success in 81% (95% CI: 78–84%) of all patients, 82% (95% CI: 79–86%) of paroxysmal AF patients, and 73% (63–83%) of persistent AF patients.…”

“…There were no significant heterogeneities noted in these analyses (I 2 = 0). Eleven studies reported the 1‐year outcome of the “bonus” strategy. Pooling data from these studies showed that during the 1‐year follow‐up, the “bonus” strategy achieved clinical success rates of 81% (95% CI: 75–86%) in all patients, 83% (95% CI: 77–89%) in paroxysmal AF patients, and 63% (95% CI: 53–73%) in persistent AF patients.…”

Shorter cryoballoon applications times do effect efficacy but result in less phrenic nerve injury: Results of the randomized 123 study

“…The incidence of PNI has been reported to increase from 2‐11% in the first‐generation balloon to 3‐24% in the second‐generation balloon . Previous study showed that the mean time to PNI was 123.6 ± 47 s (median: 131), indicating that shorter application duration might prevent the occurrence of this complication …”