Background: : The new generation ArcticFront Advance™ cryoballoon for pulmonary vein isolation (PVI) provides an optimized zone of balloon surface cooling comprising the whole frontal hemisphere.
Methods: In this retrospective study, procedural parameters, immediate procedural and safety outcome in patients treated with PVI using ArcticFront™ cryoballoon (CB) and ArcticFront Advance™ cryoballoon (CBA) were analyzed. PVI procedure was guided by three-dimensional rotational angiography (3D-RTA). PV mapping was performed using Achieve™ catheter and the endpoint was defined as complete elimination of signals at PV antrum (28mm balloon size) with verification of entrance- and exit block in each vein.
Results: In the CB-group, 53 patients (aged 63±11 years) with symptomatic AF (83% paroxysmal AF) were enrolled to undergo PVI. 30 patients (aged 59±12 years, 80% paroxysmal AF) were included in the CBA-group. The ablation endpoint was achieved in 94% (CB) and 93% (CBA), respectively. Except RIPV, compared with CB a lower minimum ablation temperature could be achieved using CBA in all PV (all p<0.01). Ablation time at each PV decreased significantly in CBA (all p<0.01) and mean procedural time was shorter in CBA (105.5 min.) compared with CB (114.2 min., p<0.05). There was no difference in number of freezes needed for PVI, fluoroscopy time and dose area product. Regarding acute safety outcome, one phrenic-nerve palsy was seen in the CB group. No other procedural related complications occurred.
Conclusions: The novel technology of ArcticFront Advance™ cryoballoon guided by 3D-RTA suggests a feasible, safe, and time-saving alternative to conventional cryoballoon ablation.