Feasibility, safety, and acute efficacy of the fourth-generation cryoballoon for ablation of atrial fibrillation: Another step forward?

Abstract

Background: The second-generation cryoballoon (CB2) is widely used for pulmonary vein (PV) isolation (PVI) in patients with paroxysmal atrial fibrillation (AF). Recently, the novel fourth-generation CB (CB-Advance PRO) was introduced, incorporating a shortened catheter tip. Hypothesis: The aim of this study was to evaluate the feasibility and acute efficacy of PVI using the CB-Advance PRO. Methods: A total of 200 consecutive patients were analyzed. Hundred patients who underwent PVI due to symptomatic, drug-refractory AF were treated with the CB-Advance PRO (group I) and were included into this multicenter analysis. A group of 100 patients were treated with the CB2 and acted as controls (group II). Results: In total, 739 of 739 PVs (100%) were successfully isolated. There was a nonsignificant trend in the incidence of online registration of PV signals between both groups (group I: 77.9% vs group II: 71.4%, P =.09). Median time to PVI (time to isolation [TTI]) and mean total freezing time were significantly shorter when using the CB-Advance PRO (group I: 33 [23, 50] vs group II: 40 [26, 60] seconds and group I: 166 ± 29 vs group II: 183 ± 38 seconds, P