Single three-minute freeze beneficial in paroxysmal A-fib

(HealthDay)—For patients with paroxysmal atrial fibrillation (PAF) undergoing pulmonary vein isolation (PVI), a single 3-minute freezing approach is as effective as a conventional 4-minute approach plus bonus application using second-generation cryoballoon (CB-Adv), according to a study published online April 11 in the Journal of Cardiovascular Electrophysiology.

Giuseppe Ciconte, M.D., from the Vrije Universiteit in Brussels, and colleagues compared the efficacy of a single 3-minute approach (3-min group) with the conventional 4-minutes plus bonus-freeze (4-min group) using CB-Adv among 160 patients undergoing PVI for PAF. Participants were randomized in a 1:1 ratio (80 patients in each group).

The researchers found that the mean procedure and fluoroscopy times were significantly shorter in the 3- versus the 4-min group (P < 0.001). The first-freeze isolation rate was 91.6 and 90.6 percent in the 4- and 3-min groups, respectively (P = 0.78). Persistent phrenic nerve palsy occurred in six and four participants in the 4- and 3-min groups, respectively (P = 0.75). Two years after the procedure, the overall freedom from atrial tachyarrhythmia (ATa) was 78.1 percent: 77.5 and 78.8 percent in the 3- and 4-min groups, respectively (P = 0.82). ATa recurrences were independently predicted by time to PVI and nadir temperature (P < 0.001).

"A 'single 3-minutes strategy' showed equal efficacy as compared to the conventional 4-minutes plus bonus freeze approach at two-year follow-up, providing shorter procedure and fluoroscopy time," the authors write.

Several authors disclosed financial ties to Medtronic and Biotronik.