Repeat procedure using radiofrequency energy for recurrence of atrial fibrillation after initial cryoballoon ablation: a 2-year follow-up

Aims The ideal energy source needed to perform ‘re-isolation’ of the pulmonary veins (PVs) during a repeat procedure for recurrence of paroxysmal atrial fibrillation (AF) has not been established yet. In this study we analysed the outcome of repeat procedure using radiofrequency (RF) energy after initial cryoballoon (CB) ablation at 2-year follow-up. Methods and results Consecutive patients having undergone PVs isolation as repeat procedure for recurrent AF after an initial CB ablation were eligible for this study. Twenty-nine patients (22 male 76%, mean age: 55 ± 17 years) were included. Mean time to repeat ablation was 12 ± 7 months. Recovered PV conduction could be documented in a mean 2.45 ± 0.7 veins in each patient. At mean 20.2 ± 10.7 months follow-up, a total of 16 patients (55%) were free of AF at without antiarrhythmic drugs (AADs). An adjunctive 31% was AF free with previously ineffective AADs. A major complication with no permanent clinical sequelae occurred only in one patient. Conclusion Repeat RF ablation following CB in case of AF recurrence is effective and safe.