Real-time (RT) recordings of the pulmonary vein (PV) electrograms can be visualized during the cryoballoon ablation (CB; Arctic Front Advance™, Medtronic, USA) using a dedicated inner lumen mapping catheter (ILMC: Achieve, Medtronic, USA). This tool provides useful information regarding time to isolation and on the conduction properties of the left atrium-pulmonary vein (LA-PV) junction [
1]. Currently, there is a great variability in ablation protocols and dosing strategies among EP Centres. Two main approaches are today most frequently used during CB ablation: (1) a signal-guided approach in which the freezing duration and quantity are titrated by the “real-time” visualization of PV potentials and (2) a temperature-guided approach where the main target is to achieve a complete PV occlusion regardless of the presence of PV potentials and the ablation strategy is then guided by the temperatures attained during the freeze. …
