• Antonio Bisignani, Ingrid Overeinder, Shuichiro Kazawa, Saverio Iacopino, Federico Cecchini, Vincenzo Miraglia, Thiago Guimarães Osório, Serge Boveda, Gezim Bala, Giacomo Mugnai, Cinzia Monaco, Erwin Ströker, Pedro Brugada, Juan Sieira, Alessio Galli, Carlo de Asmundis, and Gian Battista Chierchia.
• Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Postgraduate Course in Cardiac Electrophysiology and Pacing, European Refernce Networks Guard-Heart, Vrije Universiteit, Brussels, Belgium.
• J Interv Card Electrophysiol. 2021 Aug 1; 61 (2): 313-319.

PurposeThe purpose of the study was to evaluate the impact of left atrial posterior wall isolation (LAPWI) in addition to pulmonary vein isolation (PVI) vs PVI alone, performed using CB-A, in patients with PAF on a midterm follow-up of 12 months.MethodsEighty consecutive patients indicated to index cryoballoon ablation (CB-A) for the treatment of drug resistant PAF were included. The first 50 (62.5%) underwent PVI only, and the following 30 patients (37.5%) underwent LAPWI + PVI.ResultsAcute isolation was achieved in all PVs in both groups. The LAPW was successfully isolated in 29 out of 30 (97%) patients; in the remaining patient, adjunct radiofrequency ablation was required. The total procedure time and the mean fluoroscopy time were significantly shorter in patients who underwent PV isolation only (p < 0.001). The freedom from atrial fibrillation (AF) at 12 months was not significantly different between the 2 groups (LAPW + PVI = 90% vs PVI = 88%) (log-rank p = 0.816).ConclusionLAPW ablation in addition to PVI by the means of CB-A does not seem to reduce the risk of AF recurrence if compared with the standard PVI on a midterm follow-up of 12 months.© 2020. Springer Science+Business Media, LLC, part of Springer Nature.

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