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  • Title: Increased rate of observed real-time pulmonary vein isolation with third-generation short-tip cryoballoon.
    Author: Pott A, Petscher K, Messemer M, Rottbauer W, Dahme T.
    Journal: J Interv Card Electrophysiol; 2016 Dec; 47(3):333-339. PubMed ID: 27448816.
    Abstract:
    PURPOSE: Pulmonary vein isolation (PVI) with the cryoballoon is an established treatment for symptomatic atrial fibrillation. The second-generation cryoballoon increased efficacy in comparison to the first-generation cryoballoon. The third-generation cryoballoon was designed with a shorter distal tip to facilitate real-time recording of pulmonary vein (PV) isolation. Here, we compared the rate of real-time recordings of PVI of the second- and third-generation cryoballoon. METHODS: The incidence of real-time recording of PV isolation and time to PV isolation of the first 37 patients treated with the new third-generation cryoballoon at our center were compared to the last 37 patients treated with the second-generation cryoballoon. RESULTS: One hundred forty-nine pulmonary veins (PVs) were identified in each group. All PVs were isolated successfully with the second- or third-generation cryoballoon. Real-time registration of PVI occurred in 83 PVs (55.7 %) with the second-generation cryoballoon and in 124 PVs (83.2 %) with the third-generation cryoballoon (p < 0.001). The rate of observed real-time PVI was significantly higher with the third-generation cryoballoon for each individual PV. The time-to-isolation was 44 ± 25 s with the second-generation cryoballoon vs. 42 ± 22 s with the third-generation cryoballoon (p = 0.25). In a short-term clinical follow-up, there was no significant difference in atrial arrhythmia recurrence rates between both groups. CONCLUSIONS: The third-generation cryoballoon facilitates real-time recording of PV isolation with significantly higher rates of observed time-to-isolation. The time to PV isolation is not different between second- and third-generation cryoballoon.
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