The novel cryoballoon device appears safe and effective for patients with paroxysmal AF, but not for those with persistent AF, according to German researchers.

The novel cryoballoon device (Arctic Front, Cryocath) appears safe and effective for patients with paroxysmal atrial fibrillation (AF), but not for those with persistent AF, according to German researchers.

Dr. Thomas Neumann of Kerckhoff Heart Center, Bad Nauheim and colleagues note that a radiofrequency approach is widely used in this application. They investigated the utility of the new device in circumferential pulmonary vein electrical isolation in 293 drug refractory patients with paroxysmal AF and 53 with persistent AF.

"The 1360 of 1403 pulmonary veins (97 per cent) were targeted with balloons or balloon in combination with the use of Freezer Max (Cryocath)," the researchers report in the July 22nd issue of the Journal of the American College of Cardiology.

"The primary endpoints of this nonrandomized study," Dr. Neumann told Reuters Health, "were the acute isolation rate of the targeted pulmonary vein and the first ECG documented recurrence of AF."

After a median follow-up of 12 months, Dr. Neumann continued, "we found that ablation with the cryoballoon technique resulted in maintenance of sinus rhythm in 74 per cent of patients with paroxysmal AF, and in 38 per cent with persistent AF."

Therefore, he said, "pulmonary vein isolation with the cryoballoon technique is feasible. Sinus rhythm can be maintained in the majority of patients with paroxysmal AF by circumferential pulmonary vein isolation using a cryoballoon ablation system."

However, he and his colleagues add that "this cryoballoon ablation strategy is not recommended in patients with persistent AF."

J Am Coll Cardiol 2008;52:273-278