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

The first paragraph is an introduction. For patients with paroxysmal atrial fibrillation, cryoballoon (CB) ablation has emerged as a promising treatment for pulmonary vein isolation (PVI) (PAF). The second-generation Arctic Front Advance (ADV) was redesigned with technological changes aimed at procedural and outcome improvements. Cryoballoon (CB) technology would potentially enable PVI with a single application. The aim of this study was to compare the effectiveness of the two different technologies over a long period of time.

A total of 120 patients with PAF were enrolled in the study. PVI was performed on 60 patients with the first-generation CB and 60 patients with the ADV catheter. Over the course of a two-year follow-up period, both patients were reviewed.

There were no substantial variations between the two groups of patients as a result of the study. The first-generation CB had a longer fluoroscopy time (36.3 16.8 versus 14.2 13.5 min, resp.; p = 0.00016), as well as a longer procedure time (153.1 32 versus 10224.8 min, resp.; p = 0.019). The overall long-term performance of the two groups differed substantially (68.3 versus 86.7 percent, respectively; p = 0.017). There were no gaps in the lesion areas of the left and right PV between the two groups (p = 0.61 and 0.57, respectively). In terms of procedural problems, there were no major variations.

Conclusion: As opposed to the first-generation balloon, the ADV catheter allows for a substantially higher success rate after a single PVI procedure over the long term. Using the ADV catheter, fluoroscopy and procedure times were greatly reduced. The lesion areas formed by the two CB were not statistically different, according to electroanatomical mapping.

Author (s) Details

Sergio Conti
Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy

Claudio Tondo
Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy

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