Acute outcome after a single cryoballoon ablation: Comparison between Arctic Front Advance and Arctic Front Advance PRO. Issue 7 (15th May 2019) - Moltrasio, Massimo
Abstract: Background: The novel fourth‐generation cryoballoon (CB4) potentially allows for enhanced catheter maneuverability and more frequent capture of pulmonary vein (PV) potentials which can be used to monitor real‐time PV isolation (PVI). The aim of our study is to compare the acute procedural endpoints between the CB4 and second‐generation cryoballoon (CB2). Methods: A single‐center retrospective chart review was used to examine 50 consecutive patients with drug‐refractory atrial fibrillation undergoing CB4‐based PVI. Procedural data and acute success of these patients were compared to 50 propensity‐matched controls who underwent cryoballoon ablation procedure using CB2. Results: Procedures performed with the CB4 showed significant shorter fluoroscopy time (14.8 ± 5.5 vs 18.0 ± 6.5 minutes, P = .04), shorter procedure time (58.3 ± 15.7 vs 65.3 ± 21 minutes, P = .13), and shorter total ablation time (10.8 ± 1.5 vs 13.8 ± 1.9 minutes, P = .42). The real‐time PVI visualization rate was 33.3% in the CB2 group and 74.7% in the CB4 group ( P < .001). CB4 was correlated to significant increase of acute real‐time recordings with regard to all the single PV (left superior PV: 58% vs 84%, P = .02; left inferior PV: 26% vs 71%, P = .001; right superior PV 29% vs 61%, P = .01; and right inferior PV 19% vs 58%, P = .002). Conclusion: The CB4 was more often able to capture real‐time recordings of PV potentials and the subsequent acute PV isolation.