Straight and crosier‑shaped catheter techniques for phrenic nerve stimulation during cryoballoon pulmonary vein isolation for the treatment of atrial fibrillation

Abstract

the use of a balloon catheter is the most popular single -shot ablation technique in AF treatment. In the large FIRE AND ICE trial, 2 cryoablation was proved to be noninferior to radiofrequency ablation with respect to its efficacy. Moreover, the total procedure time and catheter dwell time in the left atrium were significantly shorter in the cryoballoon group at the cost of longer fluoroscopy time. There was also a significant difference in the occurrence of phrenic nerve injury (PNI). This complication was highly INTRODUCTION Pulmonary vein isolation (PVI) has become a standard treatment approach for symptomatic, drug -refractory paroxysmal atrial fibrillation (AF). The experts recommend catheter ablation for paroxysmal (class I; level of evidence: A) and persistent (class IIa; level of evidence: B) AF. Catheter ablation should be also considered prior to initiation of antiarrhythmic treatment in symptomatic paroxysmal or persistent AF (class IIa; levels of evidence: B/C). 1 Cryoablation of pulmonary veins with