ArticleJournal of the American Heart Association2016
Incidence and Predictors of Complications During Cryoballoon Pulmonary Vein Isolation for Atrial Fibrillation.
Article in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 45 citations in OpenAlex.
- Thermal and Non-Thermal Energies for Atrial Fibrillation Ablation.Journal of clinical medicine · 2025Review
- Phrenic nerve palsy during cryoballoon ablation of atrial fibrillation: a minor complication or a wolf in sheep's clothing? Insights on late arrhythmia recurrences from a propensity score-matched analysis.Frontiers in cardiovascular medicine · 2025Article
- Adverse events in cryoballoon ablation for pulmonary vein isolation: Insight from the Food and Drug Administration Manufacturer and User Facility Device Experience.Journal of arrhythmia · 2023Article
- Article
- Long-term results of ablation index guided atrial fibrillation ablation: insights after 5+ years of follow-up from the MPH AF Ablation Registry.Frontiers in cardiovascular medicine · 2023Article
- Safety and long-term efficacy of cryoballoon ablation for atrial fibrillation in octogenarians: a multicenter experience.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2022Article
- Persistent phrenic nerve palsy after atrial fibrillation ablation: Follow-up data from The Netherlands Heart Registration.Journal of cardiovascular electrophysiology · 2022Article
- Thermodynamic properties of atrial fibrillation cryoablation: a model-based approach to improve knowledge on energy delivery.Journal of the Royal Society, Interface · 2019Article
- Atrial Fibrillation Ablation: Indications and Techniques.Current treatment options in cardiovascular medicine · 2019Review
- Iatrogenic Arteriovenous Fistula and Atrial Septal Defect Following Cryoballoon Ablation for Atrial Fibrillation - Two Correctable Causes of Right Heart Failure.The American journal of case reports · 2019Article
- Repeat procedure is a new independent predictor of complications of atrial fibrillation ablation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2019Article
- Atrial fibrillation resulting from superior vena cava drivers addressed with cryoballoon ablation: Late reconnection at the site of phrenic nerve pacing catheter.HeartRhythm case reports · 2019Article
- Gender Differences in Atrial Fibrillation: A Review of Epidemiology, Management, and Outcomes.Current cardiology reviews · 2019Review
- Current Safety of Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation: First Experience of Same Day Discharge.Journal of atrial fibrillation · 2018Article
- Advances in management of electrophysiology and atrial fibrillation in the cardiac catheter laboratory: implications for anaesthesia.BJA education · 2018Review
- Safety and efficacy of persistent atrial fibrillation ablation using the second-generation cryoballoon.Clinical research in cardiology : official journal of the German Cardiac Society · 2018Article
- Complications of Atrial Fibrillation Cryoablation.Journal of atrial fibrillation · 2017Review
- Novel technique to avoid diaphragmatic paralysis during focal ablation of a non-pulmonary vein trigger mapped to the crista terminalis.HeartRhythm case reports · 2017Article
- Atrial Fibrillation Catheter Ablation: Overcoming Complications and Improving Success.The Journal of innovations in cardiac rhythm management · 2017Review
- Single freeze strategy with the second- generation cryballoon for atrial fibrillation: a multicenter international retrospective analysis in a large cohort of patients.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2017Article
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCryoballoon pulmonary vein isolation (PVI) has emerged as an alternative to radiofrequency PVI for atrial fibrillation (AF). Data are lacking to define the rates and predictors of complications, particularly phrenic nerve injury (PNI). METHODS AND
resultsWe evaluated a single-center prospective registry of 450 consecutive patients undergoing cryoballoon PVI between 2011 and 2015. Patients were 59±10 years old, 26% were women, 58% had hypertension, their mean CHA2DS2VASc score was 1.7±1.3, 30% had persistent atrial fibrillation, and 92% received a second-generation 28-mm balloon. Predefined major complications were persistent PNI, pericardial effusion, deep vein thrombosis, arteriovenous fistula, atrioesophageal fistula, bleeding requiring transfusion, stroke, and death. PNI was categorized as persistent if it persisted after discharge from the laboratory. Logistic regression was performed to identify predictors of complications and specifically PNI. We identified a major complication in 10 (2.2%) patients. In 49 (10.8%) patients, at least transient PNI was observed; only 5 persisted beyond the procedure (1.1%). All cases of PNI resolved eventually, with the longest time to resolution being 48 days. We also describe 2 cases of PNI manifesting after the index hospitalization. Regression analysis identified 23-mm balloon use (16.3% versus 5.2%, odds ratio 2.94, P=0.011) and increased age (62.8±7.7 versus 58.7±0.12 years, odds ratio 1.058, P=0.014) as independent significant predictors of PNI. There were no significant predictors of major complications.
conclusionsIn a large contemporary cohort, cryoballoon PVI is associated with low procedural risk, including lower rates of PNI than previously reported. Older age and 23-mm balloon use were associated with PNI. Our low rate of PNI may reflect more sensitive detection methods, including compound motor action potential monitoring and forced double-deflation.
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