Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2014, 23(5):359-366

Cryoballoon ablation: valuable enhancement of the methods of paroxysmal atrial fibrillation treatment

Bohó A1, 2, Stančák B1, 2
1 Klinika kardiológie Východoslovenský ústav srdcových a cievnych chorôb, a.s. v Košiciach
2 LF UPJŠ, Košice Slovenská republika

Pulmonary vein isolation using a cryoballoon has proven to be effective in the treatment of paroxysmal atrial fibrillation. It represents alternative for point-by-point radiofrequency ablation techniques. High procedural efficacy and low rate of major complications may be responsible for increasing interest in this method. This review explores technical, procedural and clinical aspects of cryoballoon ablation, compares it with radiofrequency ablation and points out potential drawbacks of this method.

Keywords: cryoballoon ablation; efficacy; complications; advantages; drawbacks

Published: May 1, 2014  Show citation

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Bohó A, Stančák B. Cryoballoon ablation: valuable enhancement of the methods of paroxysmal atrial fibrillation treatment. Cardiology Letters. 2014;23(5):359-366.
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    References

    1. Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace 2012;14(4):528-606. Go to original source...
    2. Haïssaguerre M, Jaïs P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Metayer P, Clementy J. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998;339(10):659-666. Go to original source...
    3. Neumann T, Vogt J, Schumacher B, Dorszewski A, Kuniss M, Neuser H, Kurzidim K, Berkowitsch A, Koller M, Heintze J, Scholz U, Wetzel U, Schneider MA, Horstkotte D, Hamm CW, Pitschner HF. Circumferential pulmonary vein isolation with the cryoballoon technique results from a prospective 3-center study. J Am Coll Cardiol 2008;52(4):273-278. Go to original source...
    4. Andrade JG, Khairy P, Guerra PG, Deyell MW, Rivard L, Macle L, Thibault B, Talajic M, Roy D, Dubuc M. Efficacy and safety of cryoballoon ablation for atrial fibrillation: a systematic review of published studies. Heart Rhythm 2011;8(9):14441451. Go to original source...
    5. Calkins H, Reynolds MR, Spector P, Sondhi M, Xu Y, Martin A, Williams CJ, Sledge I. Treatment of atrial fibrillation with anti­ arrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circ Arrhythm Electrophysiol 2009;2(4):349-361. Go to original source...
    6. Packer DL, Kowal RC, Wheelan KR, Irwin JM, Champagne J, Guerra PG, Dubuc M, Reddy V, Nelson L, Holcomb RG, Lehmann JW, Ruskin JN a Investigators., STOP AF Cryoablation. Cryoballoon ablation of pulmonary veins for paroxysmal atrial fibrillation: first results of the North American Arctic Front (STOP AF) pivotal trial. J Am Coll Cardiol 2013;61(16):17131723. Go to original source...
    7. Jackson N, Barlow M, Leitch J, Attia J. Treating atrial fibrillation: pulmonary vein isolation with the cryoballoon technique. Heart Lung Circ 2012;21(8):427-432. Go to original source...
    8. Vogt J, Heintze J, Gutleben KJ, Muntean B, Horstkotte D, Nölker G. Long-term outcomes after cryoballoon pulmonary vein isolation: results from a prospective study in 605 patients. J Am Coll Cardiol 2013;61(16):1707-1712. Go to original source...
    9. Boho A, Misikova S, Spurny P, Komanova E, Sudzinova A, Hudak M, Kerekanic M, Stancak B. Complications of circumferential pulmonary vein isolation using the cryoballoon technique: Incidence and predictors. Int J Cardiol 2014;171(2):217-223. Go to original source...
    10. Dagres N, Hindricks G, Kottkamp H, Sommer P, Gaspar T, Bode K, Arya A, Husser D, Rallidis LS, Kremastinos DT, Piorkowski C. Complications of atrial fibrillation ablation in a high-volume center in 1,000 procedures: still cause for concern? J Cardiovasc Electrophysiol 2009;20(9):1014-1019. Go to original source...
    11. Cappato R, Calkins H, Chen SA, Davies W, Iesaka Y, Kalman J, Kim YH, Klein G, Natale A, Packer D, Skanes A, Ambrogi F, Biganzoli E. Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circ Arrhythm Electrophysiol 2010;3(1):32-38. Go to original source...
    12. Van Belle Y, Janse P, Rivero-Ayerza MJ, Thornton AS, Jessurun ER, Theuns D, Jordaens L. Pulmonary vein isolation using an occluding cryoballoon for circumferential ablation: feasi­ bility, complications, and short-term outcome. Eur Heart J 2007;28(18):2231-2237. Go to original source...
    13. Van Belle Y, Janse P, Theuns D, Szili-Torok T, Jordaens L. One year follow-up after cryoballoon isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation. Europace 2008;10(11):1271-1276. Go to original source...
    14. Kuck KH, Fürnkranz A. Cryoballoon ablation of atrial fibrillation. J Cardiovasc Electrophysiol 2010;21(12):1427-1431. Go to original source...
    15. Fürnkranz A, Chun KR, Metzner A, Nuyens D, Schmidt B, Burchard A, Tilz R, Ouyang F, Kuck KH. Esophageal endoscopy results after pulmonary vein isolation using the single big cryoballoon technique. J Cardiovasc Electrophysiol 2010;21(8):869-874. Go to original source...
    16. Guiot A, Savoure A, Godin B, Anselme F. Collateral nervous damages after cryoballoon pulmonary vein isolation. J Cardiovasc Electrophysiol 2012;23(4):346-351. Go to original source...
    17. Khairy P, Dubuc M. Transcatheter cryoablation part I: preclinical experience. Pacing Clin Electrophysiol 2008;31(1):112-120. Go to original source...
    18. Ripley KL, Gage AA, Olsen DB, Van Vleet JF, Lau CP, Tse HF. Time course of esophageal lesions after catheter ablation with cryothermal and radiofrequency ablation: implication for atrio-esophageal fistula formation after catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol 2007;18(6):642646. Go to original source...
    19. Khairy P, Chauvet P, Lehmann J, Lambert J, Macle L, Tanguay JF, Sirois MG, Santoianni D, Dubuc M. Lower incidence of thrombus formation with cryoenergy versus radiofrequency catheter ablation. Circulation 2003;107(15):2045-2050. Go to original source...
    20. Sarabanda AV, Bunch TJ, Johnson SB, Mahapatra S, Milton MA, Leite LR, Bruce GK, Packer DL. Efficacy and safety of circumferential pulmonary vein isolation using a novel cryothermal balloon ablation system. J Am Coll Cardiol 2005;46(10):19021912. Go to original source...
    21. Hochholzer W, Schlittenhardt D, Arentz T, Stockinger J, Weber R, Bürkle G, Kalusche D, Trenk D, Neumann FJ. Platelet activation and myocardial necrosis in patients undergoing radiofrequency and cryoablation of isthmus-dependent atrial flutter. Europace 2007;9(7):490-495. Go to original source...
    22. Herrera Siklody C, Deneke T, Hocini M, Lehrmann H, Shin DI, Miyazaki S, Henschke S, Fluegel P, Schiebeling-Römer J, Bansmann PM, Bourdias T, Dousset V, Haïssaguerre M, Arentz T. Incidence of asymptomatic intracranial embolic events after pulmonary vein isolation: comparison of different atrial fibrill­ ation ablation technologies in a multicenter study. J Am Coll Cardiol 2011;58(7):681-688. Go to original source...
    23. Gaita F, Leclercq JF, Schumacher B, Scaglione M, Toso E, Halimi F, Schade A, Froehner S, Ziegler V, Sergi D, Cesarani F, Blandino A. Incidence of silent cerebral thromboembolic lesions after atrial fibrillation ablation may change according to technology used: comparison of irrigated radiofrequency, multipolar non­ irrigated catheter and cryoballoon. J Cardiovasc Electrophysiol 2011;22(9):961-968. Go to original source...
    24. Lowe MD, Meara M, Mason J, Grace AA, Murgatroyd FD. Catheter cryoablation of supraventricular arrhythmias: a painless alternative to radiofrequency energy. Pacing Clin Electrophysiol 2003;26(1 Pt 2):500-503. Go to original source...
    25. Collins NJ, Barlow M, Varghese P, Leitch J. Cryoablation versus radiofrequency ablation in the treatment of atrial flutter trial (CRAAFT). J Interv Card Electrophysiol 2006;16(1):1-5. Go to original source...
    26. Linhart M, Bellmann B, Mittmann-Braun E, Schrickel JW, Bitzen A, Andrie R, Yang A, Nickenig G, Lickfett L, Lewalter T. Comparison of cryoballoon and radiofrequency ablation of pulmonary veins in 40 patients with paroxysmal atrial fibrillation: a case-control study. J Cardiovasc Electrophysiol 2009;20(12):1343-1348. Go to original source...
    27. Kojodjojo P, O'Neill MD, Lim PB, Malcolm-Lawes L, Whinnett ZI, Salukhe TV, Linton NW, Lefroy D, Mason A, Wright I, Peters NS, Kanagaratnam P, Davies DW. Pulmonary ven­ ous isolation by antral ablation with a large cryoballoon for treatment of paroxysmal and persistent atrial fibrillation: medium-term outcomes and non-randomised comparison with pulmonary venous isolation by radiofrequency ablation. Heart 2010;96(17):1379-1384. Go to original source...
    28. Kühne M, Suter Y, Altmann D, Ammann P, Schaer B, Osswald S, Sticherling C. Cryoballoon versus radiofrequency catheter ablation of paroxysmal atrial fibrillation: biomarkers of myocardial injury, recurrence rates, and pulmonary vein reconnection patterns. Heart Rhythm 2010;7(12):1770-1776. Go to original source...
    29. Herrera Siklody C, Arentz T, Minners J, Jesel L, Stratz C, Valina CM, Weber R, Kalusche D, Toti F, Morel O, Trenk D. Cellular damage, platelet activation, and inflammatory response after pulmonary vein isolation: a randomized study comparing radiofrequency ablation with cryoablation. Heart Rhythm 2012;9(2):189-196. Go to original source...
    30. Chun KR, Schmidt B, Metzner A, Tilz R, Zerm T, Köster I, Fürnkranz A, Koektuerk B, Konstantinidou M, Antz M, Ouyang F, Kuck KH. The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study. Eur Heart J 2009;30(6):699-709. Go to original source...
    31. Andrade JG, Dubuc M, Guerra PG, Landry E, Coulombe N, Leduc H, Rivard L, Macle L, Thibault B, Talajic M, Roy D, Khairy P. Pulmonary vein isolation using a second-generation cryoballoon catheter: a randomized comparison of ablation duration and method of deflation. J Cardiovasc Electrophysiol 2013;24(6):692-698. Go to original source...
    32. Coulombe N, Paulin J, Su W. Improved in vivo performance of second-generation cryoballoon for pulmonary vein isolation. J Cardiovasc Electrophysiol 2013;24(8):919-925. Go to original source...
    33. Fürnkranz A, Bordignon S, Schmidt B, Gunawardene M, SchulteHahn B, Urban V, Bode F, Nowak B, Chun JK. Improved procedural efficacy of pulmonary vein isolation using the novel second-generation cryoballoon. J Cardiovasc Electrophysiol 2013;24(5):492-497. Go to original source...
    34. Metzner A, Reissmann B, Rausch P, Mathew S, Wohlmuth P, Tilz R, Rillig A, Lemes C, Deiss S, Heeger C, Kamioka M, Lin T, Ouyang F, Kuck KH, Wissner E. One-year clinical outcome after pulmonary vein isolation using the second-generation 28-mm cryoballoon. Circ Arrhythm Electrophysiol 2014;7(2):288-292. Go to original source...
    35. Chierchia GB, Di Giovanni G, Ciconte G, de Asmundis C, Conte G, Sieira-Moret J, Rodriguez-Mañero M, Casado R, Baltogiannis G, Namdar M, Saitoh Y, Paparella G, Mugnai G, Brugada P. Second-generation cryoballoon ablation for paroxysmal atrial fibrillation: 1-year follow-up. Europace 2014;16(5):639-644. Go to original source...
    36. Giovanni GD, Wauters K, Chierchia GB, Sieira J, Levinstein M, Conte G, DE Asmundis C, Baltogiannis G, Saitoh Y, Ciconte G, Julia J, Mugnai G, Irfan G, Brugada P. One-Year Follow-Up After Single Procedure Cryoballoon Ablation: A Comparison Between the First and Second Generation Balloon. J Cardiovasc Electrophysiol. 2014 Mar 18. doi: 10.1111/jce.12409. Go to original source...
    37. Fürnkranz A, Bordignon S, Dugo D, Perotta L, Gunawardene M, Schulte-Hahn B, Nowak B, Schmidt B, Chun JK. Improved 1-Year Clinical Success Rate of Pulmonary Vein Isolation with the Second-Generation Cryoballoon in Patients with Paroxysmal Atrial Fibrillation. J Cardiovasc Electrophysiol. 2014 Mar 21. doi: 10.1111/jce.12417. Go to original source...
    38. Chierchia GB, Di Giovanni G, Sieira-Moret J, de Asmundis C, Conte G, Rodriguez-Mañero M, Casado-Arroyo R, Baltogiannis G, Paparella G, Ciconte G, Sarkozy A, Brugada P. Initial experience of three-minute freeze cycles using the second-generation cryo­ balloon ablation: acute and short-term procedural outcomes. J Interv Card Electrophysiol 2014;39(2):145-151. Go to original source...
    39. Casado-Arroyo R, Chierchia GB, Conte G, Levinstein M, Sieira J, Rodriguez-Mañero M, di Giovanni G, Baltogiannis Y, Wauters K, de Asmundis C, Sarkozy A, Brugada P. Phrenic nerve paralysis during cryoballoon ablation for atrial fibrillation: a comparison between the first- and second-generation balloon. Heart Rhythm 2013;10(9):1318-1324. Go to original source...
    40. Fürnkranz A, Bordignon S, Schmidt B, Böhmig M, Böhmer MC, Bode F, Schulte-Hahn B, Nowak B, Dignaß AU, Chun JK. Luminal esophageal temperature predicts esophageal lesions after second-generation cryoballoon pulmonary vein isolation. Heart Rhythm 2013;10(6):789-793. Go to original source...
    41. Metzner A, Burchard A, Wohlmuth P, Rausch P, Bardyszewski A, Gienapp C, Tilz RR, Rillig A, Mathew S, Deiss S, Makimoto H, Ouyang F, Kuck KH, Wissner E. Increased incidence of esophageal thermal lesions using the second-generation 28-mm cryoballoon. Circ Arrhythm Electrophysiol 2013;6(4):769775. Go to original source...
    42. Lim HW, Cogert GA, Cameron CS, Cheng VY, Sandler DA. Atrio­ esophageal Fistula During Cryoballoon Ablation for Atrial Fibrillation. J Cardiovasc Electrophysiol 2014;25(2):208213. Go to original source...
    43. Bordignon S, Fürnkranz A, Schmidt B, Chun KR. Remaining ice cap on second-generation cryoballoon after deflation. Circ Arrhythm Electrophysiol 2012;5(5):e98-99. Go to original source...

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