Safety and efficacy of second-generation versus first-generation cryoballoons for treatment of atrial fibrillation: a meta-analysis of current evidence

Abstract

Second-generation cryoballoons are associated with a shorter procedure time and fluoroscopy time, along with lower arrhythmia recurrence rates, reflecting higher procedure efficacy when compared to first-generation cryoballoons. However, they are also associated with a higher incidence of transient and persistent phrenic nerve palsies with a non-significant difference in rates of access site complications and pericardial effusion.

Moderate Sedation Reduces Lab Time Compared to General Anesthesia during Cryoballoon Ablation for AF Without Compromising Safety or Long‐Term Efficacy

“…Baseline differences between GA and MS groups were addressed by multivariate analysis. Catheter generation was the strongest independent predictor of total time in laboratory, procedure time, and fluoroscopy time, consistent with prior literature reporting shorter procedure and fluoroscopy time with the second‐generation catheter …”

“…Catheter generation was the strongest independent predictor of total time in laboratory, procedure time, and fluoroscopy time, consistent with prior literature reporting shorter procedure and fluoroscopy time with the secondgeneration catheter. 13 Exclusion of subjects with inadequate rhythm follow-up may have introduced a source of bias, although this represented a small proportion of our study population. This study may not be generalizable to populations where MS is administered by anesthesiology staff rather than EP laboratory staff.…”

Pulmonary vein isolation in patients with paroxysmal atrial fibrillation

“…Several previous studies have demonstrated 1-year success rates of 81-84 % using CB-2 [8,[16][17][18]. A recent meta-analysis by Pandya et al revealed that CB-2 was associated with higher procedural efficacy compared with CB-1 as well as shorter procedural and fluoroscopy time and lower arrhythmia recurrence [19]. However, data regarding the long-term follow-up of PAF patients after second-generation CB procedures are limited.…”

Impact of Pulmonary Vein Cryoballoon Ablation on Bronchial Injury

“…The relative simplicity and gentle learning curve associated with this approach coupled with the potential for enhanced procedural efficiency have led to the prevalent adoption of this technology throughout clinical practice. Although Cryo‐PV is overall regarded as a safe ablation strategy, it can still pose a significant threat to the adjacent structures such as the esophagus, phrenic and vagus nerves, and even the bronchi . To date, there have been several published reports on unexplained pulmonary symptoms in patients who undergo Cryo‐PV raising concerns surrounding possible lung injury .…”

“…Aryana icant threat to the adjacent structures such as the esophagus, phrenic and vagus nerves, and even the bronchi. 2,3 To date, there have been several published reports on unexplained pulmonary symptoms in patients who undergo Cryo-PV raising concerns surrounding possible lung injury. [4][5][6][7][8][9][10][11] In fact, as many as 1 in 6 patients can develop a persistent dry cough following Cryo-PV, 1 and rare cases of hemoptysis have also been reported.…”