Pulmonary vein isolation with the cryoballoon technique in the management of atrial fibrillation: a single centre experience

Objectives: Pulmonary vein (PV) isolation with cryothermal energy is a recently introduced technique in patients with atrial fibrillation (AF). It may reduce procedural times and serious complications associated with radiofrequency (RF) ablation. We aimed to present the baseline characteristics and follow-up data of our study population undergoing cryoballoon AF ablation. Study design: A total of 236 patients (126 males, 110 females; mean age 54.6 +/- 10.45; range 16 to 78 years) underwent PV isolation with 28 mm cryoballoon with the indication of symptomatic AF. The treatment of these patients was unsuccessful with at least one previous antiarrhythmic drug. The postprocedural first 3 months was defined as blanking period. Median follow-up time was 14 (324) months. Procedural success, complicaitons, and follow-up results were defined according to Heart Rhythm Society guidelines. Results: Acute procedural success rate (>= 3 PV isolation) was 99.5 percent. Mean procedural and fluoroscopy times were 72.5 +/- 5.3 (50-90) min and 14 +/- 3.5 (12-24) min. Major complications were observed in 3 patients (1.2%). At the median 14 month follow-up, 80.6% of the paroxysmal AF and 49.2% of the persistent AF patients did not experience AF recurrences. RF ablation was performed in 10 patients with recurrences. Smoking, body mass index, non-paroxysmal AF type, AF duration (years), left atrial size, and early recurrence were the predictors of recurrence in multivariate regression analysis. Conclusion: This study represents the first experience with cryoballoon ablation technique for AF in Turkey The efficacy and safety of cryoballoon AF ablation technique was shown thanks to the acceptable success and low complication rates in paroxysmal AF patients. Particularly, patients who developed early recurrences should be closely followed-up.