Technical and Procedural Comparison of Two Different Cryoballoon Ablation Systems in Patients with Atrial Fibrillation

Overview

Journal J Interv Card Electrophysiol

Publisher Springer

Date 2021 Jul 28

PMID 34319493

Citations 9

Authors

Sven Knecht

Christian Sticherling

Laurent Roten

Patrick Badertscher

Laureve Chollet

Thomas Kuffer

Florian Spies

Antonio Madaffari

Aline Muhl

Samuel H Baldinger

Helge Servatius

Stefan Osswald

Tobias Reichlin

Michael Kuhne

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim was to report procedural and technical differences of a novel cryoballoon (NCB) ablation catheter for pulmonary vein isolation (PVI) compared to the standard cryoballoon (SCB) catheter.

Methods: Consecutive patients with atrial fibrillation (AF) undergoing PVI using the NCB and the SCB were included. Procedural parameters, technical differences, acute efficacy, and safety are reported.

Results: Eighty patients (age 66 ± 10 years, ejection fraction 57 ± 10%, left atrial volume index 40 ± 6 ml/m) were studied. With the NCB, 156 of 158 PVs (99%) were isolated compared to isolation of 159 of 159 PVs (100%) with the SCB. The median number of freezes in the NCB and the SCB group was 6 (IQR 5-8) and 5 (IQR 4-7), respectively (p = 0.051), with 73% and 71% of the PVs isolated with a single freeze, respectively. Nadir temperature and temperature at isolation were - 59 ± 6 °C and - 45 ± 17 °C in the NCB group and - 46 ± 7 °C and - 32 ± 23 °C in the SCB group, respectively (both p < 0.001) with no difference in time to isolation (TTI). Procedural differences were observed for the total procedure time (84 ± 29 min in the NCB group and 65 ± 17 min in the SCB group, p = 0.003). There was a peri-procedural stroke in one patient in the NCB group. Differences in catheter design were observed that may account for the differences in temperature recordings and ice cap formation.

Conclusions: Acute efficacy and TTI were similar with the NCB compared to the SCB. Measured temperatures were lower with the NCB, most likely due to differences in catheter design.

Citing Articles

Two competing cryoballoon technologies for single shot pulmonary vein isolation: first experiences with the novel system.

Imnadze G, Fink T, El Hamriti M, Bergau L, Braun M, Khalaph M Rev Cardiovasc Med. 2024; 23(4):118.

PMID: 39076243 PMC: 11274054. DOI: 10.31083/j.rcm2304118.

Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry.

Tachibana S, Miyazaki S, Nitta J, Shirai Y, Nagata Y, Sagawa Y Europace. 2024; 26(4).

PMID: 38588039 PMC: 11057019. DOI: 10.1093/europace/euae092.

Characteristics of two different cryoballoon systems for treatment of paroxysmal atrial fibrillation: study protocol for a multicenter randomized controlled trial (CONTRAST-CRYO Trial).

Ikenouchi T, Miyazaki S, Nitta J, Sekiguchi Y, Kobori A, Nakamura K J Interv Card Electrophysiol. 2023; 67(1):5-12.

PMID: 38087145 DOI: 10.1007/s10840-023-01718-2.

Difference in tissue temperature change between two cryoballoons.

Hayashi T, Hamada K, Iwasaki K, Takada J, Murakami M, Saito S Open Heart. 2023; 10(2).

PMID: 38065585 PMC: 10711899. DOI: 10.1136/openhrt-2023-002426.

Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience.

Honarbakhsh S, Martin C, Mesquita J, Herlekar R, Till R, Srinivasan N Europace. 2023; 25(11).

PMID: 37738643 PMC: 10629714. DOI: 10.1093/europace/euad286.

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