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Related Concept Videos

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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Articles linked to this work by shared authors, journal, and citation graph.

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Same author

Early recurrence of atrial tachyarrhythmia after catheter ablation and its associations with clinical outcomes, atrial fibrillation burden, and blanking period duration: A post hoc analysis of the CABANA trial.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology·2026
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Related Experiment Video

Updated: Aug 20, 2025

Direct Pressure Monitoring Accurately Predicts Pulmonary Vein Occlusion During Cryoballoon Ablation
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Cryoballoon Pulmonary Vein Isolation as First-Line Treatment for Typical Atrial Flutter.

Dhiraj Gupta1,2,3, Wern Yew Ding4,2,3, Peter Calvert4,2,3

  • 1Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK dhiraj.gupta@lhch.nhs.uk.

Heart (British Cardiac Society)
|November 17, 2022
PubMed
Summary

Cryoballoon pulmonary vein isolation (PVI) is as effective as radiofrequency cavotricuspid isthmus (CTI) ablation for treating typical atrial flutter (AFL). PVI also shows superiority in preventing new-onset atrial fibrillation (AF).

Keywords:
Ablation TechniquesArrhythmias, CardiacAtrial FibrillationAtrial FlutterCatheter Ablation

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Typical atrial flutter (AFL) is a common supraventricular tachycardia.
  • Radiofrequency cavotricuspid isthmus (CTI) ablation is a standard treatment for AFL.
  • Pulmonary vein isolation (PVI) using cryoballoon technology is an alternative ablation strategy.

Purpose of the Study:

  • To compare the efficacy and safety of cryoballoon PVI versus radiofrequency CTI ablation as a first-line treatment for typical AFL.
  • To assess the recurrence of atrial arrhythmias and the incidence of new-onset atrial fibrillation (AF) after both procedures.

Main Methods:

  • An international, multicentre, open-label trial with blinded assessment (NCT03401099).
  • Patients with CTI-dependent AFL were randomized to cryoballoon PVI or radiofrequency CTI ablation.
  • Primary efficacy endpoint: time to first recurrence of sustained symptomatic atrial arrhythmia at 12 months, assessed by implantable loop recorder.

Main Results:

  • Recruitment halted early due to the COVID-19 pandemic (113/130 patients).
  • No significant difference in the primary efficacy outcome (atrial arrhythmia recurrence) between PVI and CTI ablation groups (18.6% vs 16.7%).
  • Cryoballoon PVI significantly reduced the time to occurrence of AF (≥2 min) compared to CTI ablation.

Conclusions:

  • Cryoballoon PVI is an equally effective first-line treatment to CTI ablation for preventing atrial arrhythmia recurrence in typical AFL.
  • Cryoballoon PVI demonstrates an advantage in preventing new-onset atrial fibrillation.
  • Both PVI and CTI ablation showed comparable safety profiles in this study.