Background: Cryoballoon
(CB) ablation is successful in eliminating atrial fibrillation (AF). Purpose: The purpose of this study was
to assess procedural efficacy and safety of CB ablation performed by a newly
trained operator.
Methods: Forty
patients with documented paroxysmal AF (58 ± 11 years, 26 male) undergoing CB
catheter ablation were prospectively enrolled.
Results: Electrical
pulmonary vein (PV) isolation was achieved in all patients (156 PVs). The
primary end point (PV isolation using CB only) was reached in 31 patients (92%
PV isolation, 144/156 PVs). In the remaining 9 patients (12 PVs), additional
single point cryofocal ablations were required to achieve isolation of all
veins (LSPV, n = 5; LIPV, n = 3; LCPV, n = 2; RSPV, n = 1; RIPV, n = 1). There was
no vascular access complication, pericardial effusion/tamponade,
stroke/transient ischemic attack, phrenic nerve palsy, acute PV stenosis, or
atrioesophageal fistula. The procedure duration decreased with experience by
30% from 155 min during the first 10 procedures to 108 min (final 10
treatments). Similar effects were observed with fluoroscopy time (-57%; from 28
min to 12 min), dose area product (-66%; from 22 Gy x cm2 to 8 Gy x
cm2), CB time in the left atrium (-24%; from 99 min to 75 min), and
cryoenergy delivery time (-19%; from 83 min to 67 min), when comparing case
#1-10 to case #30-40.
Conclusions: CB
ablation of AF is effective and safe in the hands of a new operator. Procedure
and fluoroscopy times decrease with user experience.
Credits: Eberhard Scholz; Patrick Lugenbiel; Patrick A. Schweizer; Panagiotis Xynogalos; Claudia Seyler; Edgar Zitron; Rüdiger Becker; Hugo A. Katus; Dierk Thomas