Skip to main content


Impact of an additional right pulmonary vein on second-generation cryoballoon ablation for atrial fibrillation: a propensity matched score study

Journal of Interventional Cardiac Electrophysiology
Ken Takarada, Erwin Ströker, Juan-Pablo Abugattas, Valentina de Regibus, Hugo-Enrique Coutiño, Ian Lusoc, Lucio Capulzini, Juan Sieira, Giacomo Mugnai, Francesca Salghetti, Rajin Choudhury, Saverio Iacopino, Carlo de Asmundis, Pedro Brugada, Gian-Battista Chierchia



Cryoballoon (CB) technology in the context of anatomical pulmonary vein (PV) variants might hypothetically hamper successful PV isolation (PVI). Our aim was to assess the impact of a right middle PV (RMPV) in the setting of second-generation cryoballoon (CB advance—CB-A), on procedural parameters and on mid-term follow-up.


Consecutive patients with AF presenting RMPV (RMPV+) at the pre-procedural computed tomography who underwent PVI by CB-A were enrolled. Comparison with propensity score-matched patients without RMPV (RMPV−) was performed. Acute procedural parameters and clinical follow-up were assessed.


A total of 240 patients (80 RMPV+) were included in the analysis. Twelve of 80 (15%) RMPV+ patients underwent a direct cryo-application in this variant and accomplished the isolation without phrenic nerve palsy, whereas in 25 of 80 (31%) RMPV+ patients, the RMPVs were not targeted directly nor indirectly (by co-occlusion during application at a major PV). At a median follow-up of 17.3 [interquartile range 11.3–26.5] months, there was no significant difference in AF-free survival between RMPV+ and RMPV− patients (78.8 vs 78.1%, P = 1.00), and the recurrence of atrial arrhythmias among patients with versus without an intentional or indirect cryo-application to the RMPV was not different (22 vs 20%, P = 1.00).


Mid-term outcome after CB-A ablation did not differ between RMPV+ and RMPV− patients. Within RMPV+ patients, outcome was similar between those with versus without a cryo-application (either direct or indirect) to the additional vein.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Premium-Inhalten der Fachzeitschriften, inklusive eines Print-Abos.

Jetzt abonnieren und bis 25. Juni einen 50 € Amazon-Gutschein sichern.

Weitere Produktempfehlungen anzeigen
Über diesen Artikel
  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Kardiologie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Kardiologie und bleiben Sie gut informiert – ganz bequem per eMail.