Experience of Atrial Fibrillation Ablation with Third Generation Cryoballoon in a Single Center

INTRODUCTION: Atrial fibrillation (AF) continues to represent the most common form of persistent arrhythmia globally, with pulmonary vein isolation (PVI) serving as the principal method for rhythm control. The third-generation cryoballoon (CB3), engineered with a shorter distal tip, offers enhanced maneuverability and real-time feedback during ablation. We evaluated the safety, efficacy, and two-year outcomes of CB3-based pulmonary vein isolation (PVI) in atrial fibrillation patients under everyday clinical practice conditions.
METHODS: We performed a retrospective analysis of 164 patients with paroxysmal or persistent AF who underwent CB3-guided PVI between 2019 and 2022 at a high-volume electrophysiology center. Baseline clinical characteristics, procedural metrics, acute and delayed complications, and arrhythmia recurrence over 24 months were systematically evaluated.
RESULTS: The mean age of the patients was 61.2 ± 12 years; 37.2% were female, and 69.5% presented with paroxysmal AF. The average LVEF was 61.1 ± 7.3%, and the mean left atrial diameter was 40.9 ± 5.1 mm. The procedure was completed with a mean duration of 43 ± 3.1 minutes and a mean cryoapplication time of 52.7 ± 16.3 seconds. Acute procedural complications occurred in 3.1% of patients, with transient phrenic nerve palsy being the most common event. Sinus rhythm was maintained in 78.7% of patients at the 24-month follow-up.
DISCUSSION AND CONCLUSION: CB3-based cryoballoon ablation demonstrates high procedural efficiency, a low complication profile, and durable rhythm control over mid-term follow-up. These findings support CB3 as a reliable first-line strategy for AF ablation in contemporary clinical practice.

Keywords: Atrial Fibrillation, Catheter Ablation, Cryoballoon Ablation, Third-Generation Cryoballoon,