Best Practice Guide for Cryoballoon Ablation in Atrial Fibrillation: The Compilation Experience of More than 1000 Procedures

Dimitriοs Tsiachris, Christos-Konstantinos Antoniou, Ioannis Doundoulakis, Panagiota Manolakou, Demetrios Sougiannis, Athanasios Kordalis, Konstantinos A Gatzoulis, Gian-Battista Chierchia, Carlo de Asmundis, Christodoulos Stefanadis, Konstantinos Tsioufis

Research output: Contribution to journalArticlepeer-review


Nowadays, the cryoballoon (CB) constitutes an established alternative to radio frequency (RF) ablation for pulmonary vein isolation (PVI), which offers the possibility to isolate the PVs with a single application. Since the introduction of the second-generation CB, we prospectively collected our data to optimize the procedure on >1000 consecutive patients who underwent CB PVI performed in our center. It is expected that subsequent guidelines will suggest first-line PVI through CB in patients with paroxysmal AF with a class I indication. Indeed, in the long-term follow-up (36 months) of the EARLY-AF trial, CB had a lower incidence of persistent atrial fibrillation episodes compared to the anti-arrhythmic drugs group. We now review the current best practices in an effort to drive consistent outcomes and minimize complications. PV isolation through CB is the most studied single-shot technique for atrial fibrillation ablation, having shown the potential to alter the natural history of the arrhythmia. Several procedural tips and tricks can improve procedural flow and effectiveness. In the present article we provided not only technical details but measurable biophysical parameters that can reliably guide the operator into achieving the best outcome for his patients.

Original languageEnglish
Article number55
Pages (from-to)55-55
Number of pages1
JournalJournal of cardiovascular development and disease
Issue number2
Publication statusPublished - 30 Jan 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Copyright 2023 Elsevier B.V., All rights reserved.


  • atrial fibrillation
  • cryoballoon ablation
  • review
  • time to isolation

Cite this