Single freeze strategy with the second- generation cryballoon for atrial fibrillation: a multicenter international retrospective analysis in a large cohort of patients

Abstract

Single freeze CB-A ablation is effective in treating drug-resistant AF and affords freedom from arrhythmia recurrences in 84.6% of patients during a 14-month follow-up. Persistent AF and recurrence during BP are predictors of arrhythmia recurrences.

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

“…In this study, the number of successfully isolated PVs after a single application is similar to earlier reports using 180 and 240 s application durations …”

“…With the advent of the second generation cryoballoon, efficacy increased but it caused a decrease in safety, especially for right PNI . As a result, the paradigm shifted from efficacy to safety and, in recent years, the use of single applications and applications without bonus applications after successful isolation has been explored . The omission of bonus applications did not compromise the efficacy of PVI and, depending on the PV, the mean number of applications needed for isolation was found to be between 1 and 2 .…”

Intracardiac ablation for atrioventricular nodal reentry tachycardia using a 6 mm distal electrode cryoablation catheter: Prospective, multicenter, North American study (ICY‐AVNRT STUDY)

“…The first freeze likely interrupts the microcirculation of warm blood such that the second freeze meets less thermal resistance, resulting in an even steeper temperature decline curve and a larger volume of ablated tissue. By contrast, cryoballoon catheter ablation in patients with atrial fibrillation has demonstrated effectiveness of a single‐freeze application during pulmonary vein isolation . However, to our knowledge, there is no pivotal study examining the efficacy of a single‐freeze approach in the focal cryoablation of AVNRT.…”

“…By contrast, cryoballoon catheter ablation in patients with atrial fibrillation has demonstrated effectiveness of a single-freeze application during pulmonary vein isolation. 17,18 However, to our knowledge, there is no pivotal study examining the efficacy of a single-freeze approach in the focal cryoablation of AVNRT.…”

Strategies to Improve the Outcome of Cryoballoon Ablation in the Treatment of Atrial Fibrillation

“…BioMed Research International encouraging finding did not support the development of the bonus freeze protocol. Other research found that, after a signal freeze, almost 80.4%-84.6% of PaAF and PeAF patients were free from atrial arrhythmias at a midterm follow-up without increased complications [24][25][26]. To compare the outcomes between a signal and bonus freeze delivery, control studies were also carried out that found no significant differences in rates of success, reoccurrences, or complications.…”