An Apparent Way of Achieving Proof of Pulmonary Vein Disconnection during Cryoballoon Ablation

Abstract

Pulmonary vein isolation (PVI) has established itself as a standard therapy for paroxysmal atrial fibrillation (AF). Still, the most widely performed procedure of point-by-point distal-tip ablation using a 3-dimensional mapping system and a circular catheter to validate PVI remains a complex, elaborative, and time-consuming procedure. This explains the many efforts being made over the recent years to simplify and shorten PVI procedures without compromising the efficacy or the safety. The cryoballoon (Ablation Frontiers, Medtronic, Inc., Minneapolis, MN, USA) is a recently introduced "single shot ablation tool" to facilitate PVI. Initial studies on efficacy and safety of this device are encouraging in patients with paroxysmal AF. However, several controversies remain, such as the need for an additional circular mapping catheter to validate PVI and the lack of on-line PV recording during freezes. One of the most recent developments in this field is the Achieve circular mapping catheter (Ablation Frontiers, Medtronic, Inc.). We describe an apparent case in which this tool is used in conjunction with the cryoballoon.