Comparison between First- and Second-Generation Cryoballoon for Paroxysmal Atrial Fibrillation Ablation

Abstract EN

Introduction.

Cryoballoon (CB) ablation has emerged as a novel treatment for pulmonary vein isolation (PVI) for patients with paroxysmal atrial fibrillation (PAF).

The second-generation Arctic Front Advance (ADV) was redesigned with technical modifications aiming at procedural and outcome improvements.

We aimed to compare the efficacy of the two different technologies over a long-term follow-up.

Methods.

A total of 120 patients with PAF were enrolled.

Sixty patients underwent PVI using the first-generation CB and 60 patients with the ADV catheter.

All patients were evaluated over a follow-up period of 2 years.

Results.

There were no significant differences between the two groups of patients.

Procedures performed with the first-generation CB showed longer fluoroscopy time (36.3±16.8 versus 14.2±13.5 min, resp.; p=0.00016) and longer procedure times as well (153.1±32 versus 102±24.8 min, resp.; p=0.019).

The overall long-term success was significantly different between the two groups (68.3 versus 86.7%, resp.; p=0.017).

No differences were found in the lesion areas of left and right PV between the two groups (resp., p=0.61 and 0.57).

There were no significant differences in procedural-related complications.

Conclusion.

The ADV catheter compared to the first-generation balloon allows obtaining a significantly higher success rate after a single PVI procedure during the long-term follow-up.

Fluoroscopy and procedural times were significantly shortened using the ADV catheter.