Pulmonary vein isolation using the cryotherapy: Artic Front versus Artic Front Advance

Introduction: The purpose of this study is to investigate the intraoperative parameters and the success rate of the cryoablation of atrial fibrillation in a significant lot of 639 patients. Methods: A group of 639 patients with paroxysmal, persistent or permanent atrial fibrillation (AF) benefi ted from pulmonary vein isolation (IVP) using the cryoablation balloon, between 12 November 2007 – 18 March 2014, at University Hospital in Grenoble, France, and in the Center for Research and Invasive Treatment of Atrial Fibrillation in Iași, Romania. 441 patients were included in the Arctic Front (AFb) subset and the remaining 205 patients were included in the Arctic Front balloon Advance (AFAb) subset. We analysed the two subgroups, comparing the procedure time, the rate of complications and success rate during the mean follow-up time. Results: The mean duration of the procedure was significantly reduced by using AFAb (135 minutes for the AFb subset, 104 minutes for the AFAb subset, p < 0.001), as the mean fluoroscopy time (23 minutes for the AFb subset and 13 minutes for the AFAb subset, p < 0.001). There was no significant difference between the mean IVP time for the patients that were atrial fibrillation free or not (58 seconds and 48 seconds, respectively, p = 0.09). For the paroxysmal AF, the success rate was 61.5% for a mean follow-up of 27.6 months using AFb and 85.5% for a median follow-up of 7 months, using AFAb. Complications were represented by phrenic nerve palsy (6.36% of cases), pericardial fl uid without surgical correction (1.17%), pericardial tamponade (1.17%), embolism (1.17%) and bacterial endocarditis (0.23%). Conclusions: The results of the study show a significant improvement in the success rate of the procedure using the AFAb, confirming the benefits of the widespread use of this technique for pulmonary vein isolation by cryotherapy

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)