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Cryoballoon ablation for atrial fibrillation

N Pavlovic, S Knecht, T Reichlin, M Khne & C Sticherling

Atrial fibrillation is the most common cardiac arrhythmia occurring in 1–2% of the general population. It is associated with a reduction of functional status, quality of life and overall survival as well as with an increase in hospital admissions and stroke rate. Pulmonary vein (PV) isolation is the cornerstone of the interventional treatment of atrial fibrillation. Catheter ablation using radiofrequency (RF) energy has been shown to reduce symptoms, improve quality of life, and decrease hospitalizations. Cryoablation using a balloon catheter (Arctic Front Advance, Medtronic CryoCath) has emerged as an alternative to RF ablation (RFA) for achieving PV isolation. In this article we will review the biophysics of cryothermal tissue injury and the contemporary role of cryoablation in PV isolation. Also, anatomical predictors of successful cryoablation, complications and future perspectives will be discussed