Volume 13, Issue 12, Pages (December 2016)

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Volume 13, Issue 12, Pages 2306-2313 (December 2016) Catheter ablation using the third-generation cryoballoon provides an enhanced ability to assess time to pulmonary vein isolation facilitating the ablation strategy: Short- and long-term results of a multicenter study Arash Aryana, MS, MD, FHRS, Marcin Kowalski, MD, FHRS, Padraig Gearoid O’Neill, MD, FHRS, Charles H. Koo, MD, Hae W. Lim, PhD, Asif Khan, MD, Robert B. Hokanson, BA, Mark R. Bowers, MS, MD, David N. Kenigsberg, MD, FHRS, Kenneth A. Ellenbogen, MD, FHRS Heart Rhythm Volume 13, Issue 12, Pages 2306-2313 (December 2016) DOI: 10.1016/j.hrthm.2016.08.011 Copyright © 2016 The Authors Terms and Conditions

Heart Rhythm 2016 13, 2306-2313DOI: (10.1016/j.hrthm.2016.08.011) Copyright © 2016 The Authors Terms and Conditions

Figure 1 An illustration depicting the principal design change between the AFA and the AFA-ST cryoballoons. As shown, the length of the distal tip (L) of the AFA-ST cryoballoon is ~40% shorter than that of the AFA balloon (8 mm vs 13 mm, respectively), thereby allowing farther withdrawal (d) of the inner lumen circular mapping catheter through the inner lumen of the cryoballoon to a more proximal location within the pulmonary vein ostia. AFA = Arctic Front Advance; AFA-ST = Arctic Front Advance-Short Tip. Heart Rhythm 2016 13, 2306-2313DOI: (10.1016/j.hrthm.2016.08.011) Copyright © 2016 The Authors Terms and Conditions

Figure 2 Assessment of TT-PVI by the number of PVs per patient. The frequency of recording TT-PVI in 1 PV per patient (97% vs 83%; P < .001), in 2 PVs per patient (88% vs 62%; P < .001), and in 3 PVs per patient (64% vs 40%; P < .001) was greater using AFA-ST versus AFA. While there was a trend toward improved recording of TT-PVI in all PVs per patient (34% vs 25%; P = .072), this did not reach statistical significance. AFA = Arctic Front Advance; AFA-ST = Arctic Front Advance-Short Tip; PV = pulmonary vein; TT-PVI = time to pulmonary vein isolation. Heart Rhythm 2016 13, 2306-2313DOI: (10.1016/j.hrthm.2016.08.011) Copyright © 2016 The Authors Terms and Conditions

Figure 3 Cumulative freedom from recurrent atrial arrhythmias after cryoballoon ablation of atrial fibrillation. A Kaplan-Meier curve illustrating the cumulative freedom from recurrent atrial arrhythmias after cryoablation using the AFA vs the AFA-ST cryoballoons, including the number of patients at risk. AFA = Arctic Front Advance; AFA-ST = Arctic Front Advance-Short Tip. Heart Rhythm 2016 13, 2306-2313DOI: (10.1016/j.hrthm.2016.08.011) Copyright © 2016 The Authors Terms and Conditions