Best practice guide for cryoballoon ablation in atrial fibrillation: The compilation experience of more than 3000 procedures

Abstract

Background: Since the release of the second-generation cryoballoon (CB2; Arctic Front Advance(TM), Medtronic Inc) and its design modifications with improved cooling characteristics, the technique, dosing, and complication profile is significantly different from that of the first-generation cryoballoon. A comprehensive report of CB2 procedural recommendations has not been reported.

Objective: The purpose of this study was to review the current best practices from a group of experienced centers to create a user's consensus guide for CB2 ablation.

Methods/results: High-volume operators with a combined experience of more than 3000 CB2 cases were interviewed, and consensus for technical and procedural best practice was established.

Conclusion: Comprehensive review of the CB2 ablation best practice guide will provide a detailed technique for achieving safer and more effective outcomes for CB2 atrial fibrillation ablation.

Keywords: Atrial fibrillation; Balloon; Cryoablation; Cryoballoon; Paroxysmal atrial fibrillation; Phrenic nerve; Practice guidelines; Pulmonary vein isolation; Second-generation cryoballoon.