Second versus fourth generation of cryoballoon catheters: The 1STOP real‐world multicenter experience

Abstract

It has been observed that the fourth-generation cryoballoon (CB4) ablation catheter increased the rate of acute real-time recordings of pulmonary vein isolation (PVI) during the ablation for the treatment of atrial fibrillation (AF). The aim of this analysis was to compare the long-term outcome results between patients treated with the CB4 and second-generation cryoballoon (CB2). In total, 492 patients suffering from AF, underwent PVI ablation with either the CB2 or CB4 catheter within this examination of the 1STOP real-world Italian project and were included in the analysis. Specifically, 246 consecutive patients treated by CB4 were compared to 246 propensity-matched control patients who underwent PVI using CB2. When comparing the patient cohorts treated with CB2 versus CB4, acute success rate (99.6 ± 4.7%vs. 99.7 ± 3.6%, p=.949) and peri-procedural complications (3.7%vs.1.2%, p=.080) were similar in both groups, respectively. However, procedure time (100vs.75min, p<.001) and fluoroscopy duration (21vs.17min, p<.001) were all significantly lower in the CB4 treated patient cohort. At the 12-month follow-up, the freedom from AF recurrence after a 90-day blanking period was significant higher in the CB4 as compared with the CB2 group (93.3%vs.81.3%, p<.001). In summary, usage of the CB4 ablation catheter increased the rate of acute PVI recording capability and resulted in a higher rate of long-term PVI success, as demonstrated by the reduced rate of AF recurrence in comparison to the CB2 cohort at the 12-month follow-up period.