Abstract 2543: The Permanency of PV Isolation With a Cryoballoon Catheter During AF Ablation
Background: Achieving permanent pulmonary vein isolation (PVI) with RF ablation continues to be an elusive goal for most operators. On the other hand, balloon cryoablation is being increasingly employed for PVI, and the early data have demonstrated the feasibility to achieve acute PVI, but little data are available on the durability of PV isolation.
Methods: Twelve PAF patients (54+11yrs; 9M/3F) underwent PVI using either a 23mm (6pts) or 28mm (6pts) cryoballoon (Arctic Front, Cryocath Inc). After verifying electrical isolation with a circular mapping catheter, 2 bonus balloon ablation lesions/PV were placed. Conduction gaps were targeted with an 8mm-tip cryocatheter. The chronicity of PVI was assessed by a pre-specified 2nd procedure at 8 wks.
Results: Acute PVI was achieved in all veins (n=48 PVs), using the cryoballoon alone in 47/48 (98%) PVs; the spot catheter closed the remaining gap. PV re-mapping revealed that 42/48 (88%) PVs remained chronically isolated; there was no difference with the use of either balloon. One vein had reconnected in 2/48 patients, while 2 veins had reconnected in another 2 patients. Of the 4 pts with PV reconnection, 3 had recurrent AF in the intervening period.
Conclusions: The cryoballoon ablation procedure is able to achieve persistent isolation in most PVs. This may represent a significant step toward standardizing the PVI procedure.