Pulmonary vein isolation using the second-generation cryoballoon significantly increased indexed troponin T release compared to the first-generation (32.3 vs 18.8 pg/L/min; P<0.01).
Observational (n=66)
Does the second-generation 28 mm cryoballoon increase myocardial biomarker release and improve success rates compared to the first-generation cryoballoon in patients undergoing pulmonary vein isolation for atrial fibrillation?
The second-generation 28 mm cryoballoon produces greater myocardial injury (assessed by biomarker release) and improves 6-month procedural success compared to the first-generation device for atrial fibrillation ablation.
Absolute Event Rate: 32.3% vs 18.8%
p-value: p=<0.01
AIMS: Recently, a novel second-generation (G2) cryoballoon (CB) was introduced. Comparative analysis of lesion formation in terms of myocardial biomarker release first-generation CB (G1) vs. G2 has not been studied. To compare myocardial biomarker release using the 28 mm G1 vs. G2 CB. METHODS AND RESULTS: In patients (patients) treated with the simplified single big CB (SBCB) strategy for pulmonary vein isolation (PVI), myocardial biomarkers troponin T (TnT), creatine kinase, lactic dehydrogenase (LDH) were measured at 12, 24, and 48 h after PVI. Two groups were defined: Group 1 (G1; freezing time: 300 s), Group 2 (G2; freezing time: 240 s). Mean biomarker peak values were compared. To correct for between-group differences in cumulative freezing time, an index calculated as peak biomarker release divided by cumulative freezing time was calculated. Sixty-six CB PVI procedures (G1: 33 patients, G2: 33 patients) were analysed. Pulmonary vein isolation was achieved in all the patients using the simplified SBCB technique only. Mean freezing time (51 ± 10 vs. 33 ± 6 min, P < 0.01) was significantly shorter in G2. All biomarker levels tended to be higher in G2 vs. G1. The indexed biomarkers values were significantly higher in G2: TnT: 18.8 ± 8.5 vs. 32.3 ± 13.6 pg/L/min (P < 0.01); creatinephosphokinase: 6.7 ± 2.7 vs. 11.7 ± 3.9 U/L/min (P < 0.01); LDH: 5.2 ± 1.0 vs. 9.1 ± 2.7 U/L/min (P < 0.01). On a 6-month follow-up (180 days), G2 revealed a significantly higher success rate (20/33 vs. 28/33; P = 0.027). CONCLUSION: Pulmonary vein isolation using the G2 CB increased the myocardial biomarker release index and is linked to a significantly improved 6 months success rate.
Bordignon et al. (2014) conducted an observational in Atrial fibrillation (n=66). Second-generation (G2) 28 mm cryoballoon vs. First-generation (G1) 28 mm cryoballoon (300 s freezing time) was evaluated on Indexed troponin T (TnT) release (pg/L/min) (p=<0.01). Pulmonary vein isolation using the second-generation cryoballoon significantly increased indexed troponin T release compared to the first-generation (32.3 vs 18.8 pg/L/min; P<0.01).