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Europace 2008 10(11):1271-1276; doi:10.1093/europace/eun218
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org
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Ablation for atrial fibrillation

One year follow-up after cryoballoon isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation

Yves Van Belle*, Petter Janse, Dominic Theuns, Tamas Szili-Torok and Luc Jordaens

Clinical Electrophysiology Unit, Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands

Aims: Pulmonary vein isolation (PVI) with cryoenergy delivered through a balloon is a new approach in the treatment of atrial fibrillation (AF), but long-term follow-up is lacking. The aim of this study was to provide insight in the success rate and the incidence of recurrences.

Methods and results: Patients with symptomatic AF despite anti-arrhythmic drugs (AADs) were treated with cryoballoon PVI. Daily transtelephonic ECG monitoring, 24 h Holter-ECG, and an arrhythmia-focused questionnaire were used to document AF. One hundred and forty-one patients completed a follow-up of 457 ± 252 days. Before ablation, Holter-ECG showed AF in 45%, including 16% continuous AF throughout the recording. Event recording revealed a median AF burden of 26%. The questionnaire showed a median of weekly AF complaints lasting for hours. All but one patient had successful PVI with a single procedure. After ablation, AF (defined as lasting for more than 30 s) was seen in 11% of Holter-ECGs, with 1% continuous AF. The event recording showed an AF burden of 9%. The median patient reported no more AF-related symptoms. Recurrence during the first 3 months was predictive for later recurrence. A second procedure was performed in 24 patients. The freedom of AF was 59% without AADs after 1,2 procedures. Four right phrenic nerve paralyses occurred, all resolving within 6 months. No PV stenoses were observed.

Conclusion: Pulmonary vein isolation with a cryothermal balloon is an effective treatment for paroxysmal AF, resulting in a clinical success rate comparable to studies involving radiofrequency ablation. Temporary right phrenic nerve paralysis is the most important complication.

Key Words: Ablation, Atrial fibrillation, Cryoablation, Cryoballoon, Follow-up

* Corresponding author. Tel: +31107033991; fax: +31107034420. E-mail address: y.vanbelle{at}erasmusmc.nl

Manuscript submitted 3 June 2008. Accepted after revision 1 August 2008.


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