• Heart Rhythm · Aug 2017

    Multicenter Study

    Acute efficacy, safety, and long-term clinical outcomes using the second-generation cryoballoon for pulmonary vein isolation in patients with a left common pulmonary vein: A multicenter study.

    • Christian-Hendrik Heeger, Verena Tscholl, Erik Wissner, Thomas Fink, Laura Rottner, Peter Wohlmuth, Barbara Bellmann, Mattias Roser, Shibu Mathew, Christian Sohns, Bruno Reißmann, Christine Lemeš, Tilman Maurer, Francesco Santoro, Johannes Riedl, Britta Goldmann, Ulf Landmesser, Feifan Ouyang, Karl-Heinz Kuck, Andreas Rillig, and Andreas Metzner.
    • Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany. Electronic address: christian.heeger@gmx.net.
    • Heart Rhythm. 2017 Aug 1; 14 (8): 1111-1118.

    BackgroundSecond-generation cryoballoon (CB2)-based pulmonary vein isolation (PVI) has demonstrated encouraging clinical results in the treatment of paroxysmal (PAF) and persistent atrial fibrillation (PersAF). However, the CB2 features a maximal diameter of 28 mm, and its adaptability to anatomic variations of the pulmonary veins (PVs) might be challenging.ObjectiveThe purpose of this study was to assess the acute efficacy, safety, and long-term clinical results of CB2-based PVI in patients with a left common pulmonary vein (LCPV).MethodsSix hundred seventy consecutive patients underwent CB2-based PVI in 3 electrophysiology centers. In 74 patients (11%), an LCPV was identified (LCPV group). The data were compared to those from matched patients (n = 74) with normal PV anatomy and comparable baseline characteristics (control group). An antral occlusion of the complete LCPV ostium was feasible in 50% of patients in the LCPV group. If an antral occlusion could not be obtained, a sequential isolation of the first superior and inferior branches was applied.ResultsAll 74 LCPVs were successfully isolated. A total of 64% patients (LCPV group) and 66% patients (control group) remained in sinus rhythm after mean follow-up of 1.9 ± 0.9 years (P = .820). In 18 of 26 patients (69%) with atrial tachyarrhythmia recurrence, a repeat procedure using radiofrequency energy was performed, and a total of 56% LCPVs were found to be persistently isolated (control group: 61% of left-sided PVs, P = .801).ConclusionPatients with an LCPV undergoing CB2-based PVI demonstrate a high acute success rate. Comparable results with regard to clinical success and durability of PVI were shown when comparing patients of the LCPV group and the control group.Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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