Additional left atrial lesions improve the effect of cryoballoon pulmonary vein isolation in paroxysmal atrial fibrillation patients

Aim. Cryoballoon ablation (CBA) is one of the methods for catheter pulmonary vein isolation (PVI) paroxysmal atrial fibrillation (AF). Left additional lesion (LAAL) to PVI were proposed eliminate extrapulmonary AF triggers. Nonetheless whether lesions improve CBA effectiveness not clear. Methods. Primary procedures performed during 2017-2021 analyzed. The study group (Algorithm group, n=82) was recruited prospectively in 2019-2021. As first step all pts. In those who on sinus rhythm (SR) after PVI, induction attempts with burst pacing performed. Pts induced and stayed underwent LAAL at left ganglionated plexus area. case stable SR (non-inducible AF) procedure finished. If inducible or did terminate CBA, second set - LA posterior wall lesions. still terminate, restored by electrical cardioversion. control (Control n=94) formed retrospectively from patients routinely only achievement criteria 2017-2019. continued, There no procedure. Results. Algorithm Control groups comparable terms clinical, demographic electrophysiological characteristics. At 12 months postoperatively, higher than (78.0% vs. 62.8%, p = 0.044). No adverse effects found. Conclusion. Thus, stepwise approach increases long-term period does affect risk complications.