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Cryoballoon ablation has been demonstrated to allow safe and effective isolation of pulmonary veins (PV) for the treatment of paroxysmal atrial fibrillation. Recently, the second-generation cryoballoon device has been developed (Arctic Front Advance, Medtronic CryoCath LP) with improved cooling capabilities by increasing the number of refrigerant injectors, resulting in homogeneous cooling of the balloon surface. In contrast, the first-generation balloon is characterized by a cooling zone concentrated on the equator of the balloon with less cooling around the frontal nose. This limitation is hypothesized to result in incomplete lesion formation in the myocardium contacting this area, specifically the inferior circumference of the inferior PVs.1 The nonhomogeneous cooling of the first-generation device may also explain a relative long time to left atrium-PV block recorded …

Remaining Ice Cap on Second-Generation Cryoballoon After Deflation