A novel double cryoballoon strategy in persistent atrial fibrillation: A pilot study

Martin Schmidt, Uwe Dorwarth, Florian Straube, Michael Wankerl, Jürgen Krieg, Alexander W. Leber, Hans Ullrich Ebersberger, Marcos Daccarett, Armin Huber, Ernst Rummeny, Ellen Hoffmann

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Aims Cryoballoon technology is a promising technique in paroxysmal atrial fibrillation (AF) ablation. However, success rates in patients with persistent AF have not been convincing. There is a trend toward performing more extensive procedures that are referred to as 'pulmonary vein isolation plus.' To combine pulmonary vein isolation (PVI) and antral substrate modification, we used both the 23-mm and 28-mm cryoballoon in a single approach in patients with persistent AF. Methods and results 33 consecutive patients (26 men, age 60 ± 10 years, LA size 44 ± 5 mm) with persistent AF were prospectively included. All patients underwent the 'double balloon strategy:' at least two applications at each pulmonary vein (PV) using the smaller 23-mm balloon to isolate the PV at the ostial level plus at least one additional freeze by the 28-mm balloon at the wide PV antral level. 7-day Holter monitors were performed during follow-up at 1, 3, 6, 9, 12, 18 and 24 months post-ablation. 131 of 133 PVs were targeted and isolated (98.4 %). A mean of 14 ± 2 cryoballoon applications per patient or 3.5 ± 1.5 applications per vein were performed. After a single procedure and mean follow-up of 15 ± 3 months, 69.7 % of patients remained in sinus rhythm (3-month blanking period). There were no major complications. Conclusions In persistent AF, the 'double balloon strategy;' combining the small and large cryoballoon allowed ostial PV isolation followed by antral cryoablation is feasible, safe and associated with a favorable outcome.

Original languageEnglish
Pages (from-to)777-785
Number of pages9
JournalClinical research in cardiology : official journal of the German Cardiac Society
Volume101
Issue number10
DOIs
StatePublished - Oct 2012

Keywords

  • Catheter ablation
  • Cryoballoon
  • Double balloon strategy
  • Persistent atrial fibrillation

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