Cryoballoon Pulmonary Vein Isolation for the Treatment of Atrial Fibrillation and Issues in Follow-up Management

Since the fi rst publication proving the causal relation between electrically active muscular sleeves in the pulmonary veins (PV) and the triggering of paroxysmal atrial fi brillation (AF) by ectopic beats originating from them, numerous endocardial ablation techniques have been used to eliminate this arrhythmia. Although well established as a standard procedure in the treatment of atrial fi brillation, point-to-point radiofrequency ablation remains a challenging procedure, in which manual operator skills and experience is highly variable. This currently translates in variable success rates and high complication rates, making the risk-benefi t evaluation of this procedure diffi cult to assess. Several devices have been engineered to simplify the circumferential ablation, with the aim of permitting less experienced operator to achieve the endpoint of PV isolation with reasonable procedure and fl uoroscopy times, and without a higher risk of complications.