ArticleClinical research in cardiology : official journal of the German Cardiac Society2025
Temperature to time Catch-Up: a novel procedural endpoint to predict durable pulmonary vein isolation after cryoballoon ablation of paroxysmal atrial fibrillation.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Comparison of Single-Freezing Temperature-Guided and Conventional Time-to-Isolation-Guided Protocols of Cryoballoon in Atrial Fibrillation Ablation.Cardiology research · 2026Article
- Mechanistic insights into the learning curve of cryoballoon ablation: ablation temperature mediates the effect of operator experience on radiation exposure.Frontiers in cardiovascular medicine · 2026Article
- Cardiac sarcoidosis in patients with recurrent ventricular arrhythmias refractory to endocardial ablation.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
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15 authors.
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Abstract
backgroundCryoballoon ablation is a widely used single-shot technique for pulmonary vein isolation (PVI) in the treatment of paroxysmal atrial fibrillation (AF). Procedural endpoints ensuring maximal PVI durability are important.
objectiveTo assess the performance of cryoablation procedural markers to predict long-term PVI.
methodsIn a single center, consecutive patients who underwent redo ablation with high-density mapping for symptomatic AF recurrence after cryoballoon ablation were included and cryoballoon procedural data were collected, including temperature values at 30 and 60 s, time to isolation, nadir temperature and the velocity of temperature decline estimated with the temperature/time catch-up point (T2T-Catch-Up) defined as positive when the freeze temperature in minus degree equals the time in seconds after cryoablation initiation (e.g. - 15 °C in the first 15 s of the ablation impulse).
results47 patients (62% male; 58.3 ± 11.2 years) were included. Overall, 38 (80.9%) patients had ≥ 1 reconnected PV. Among 186 PVs, 56 (30.1%; 1.2 per patient on average) were reconnected. Univariate analysis revealed T2T-Catch-Up in 103 (56%) and more frequent in durably isolated than in reconnected PVs (93 [72%] vs 10 [19%], p < 0.0001). Among binary endpoints, T2T-Catch-Up had the highest specificity (82%) and predictive value for durable PVI at redo ablation (90%). In multivariable analyses, absence of T2T-Catch-Up (Odds-ratio 0.12, 95% CI [0.05-0.31], p < 0.0001) and right superior PV (Odds-ratio 3.14, 95% CI [1.27-7.74], p = 0.01) were the only variables independently associated with PV reconnection.
conclusionT2T-Catch-Up, a new and simple cryoballoon procedural endpoint demonstrated excellent predictive value and strong statistical association with durable PVI.
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