Frozen Hearts: The Emerging Role of Cryoablation for Pulmonary Vein Isolation

Abstract

The cornerstone for the modern treatment of paroxysmal atrial fibrillation (AF) is pulmonary vein isolation, also called an AF ablation. Various ablation technologies exist to accomplish this goal with specific advantages. This chapter will focus on the unique attributes of cryoablation for pulmonary vein isolation. Specifically, we will summarize the trial data and outcomes of cryoablation in patients with paroxysmal and persistent AF from the initial FDA approval studies to novel uses beyond the pulmonary veins. Readers will have an appreciation of the unique characteristics differentiating cryoablation from radiofrequency (RF) catheter ablation and other techniques such as surgical MAZE. Clinical trial data show both noninferiority, and in some cases, superior outcomes of cryoablation to antiarrhythmic drug therapy and other ablation techniques.