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Background  Rhythm outcomes after the pulmonary vein isolation ( PVI ) using the cryoballoon ( CB ) are reported to be excellent. However, the lesions after  CB  ablation have not been well discussed. We sought to characterize and compare the lesion formation after  CB  ablation with that after radiofrequency ( RF ) ablation.    Methods  A total of 42 consecutive patients who underwent  PVI  were enrolled (29 in the  CB  group and 13 in the  RF  group). The  PVI  lesions were assessed by late gadolinium enhancement magnetic resonance imaging 1–3 months after the  PVI . The region around the  PV s was divided into eight segments: roof, anterior‐superior, anterior‐carina, anterior‐inferior, bottom, posterior‐inferior, posterior‐carina, and posterior‐superior segment. The lesion width and lesion gap in each segment were compared between the two groups. Lesion gaps were defined as no‐enhancement sites of >4 mm.    Results  As compared to the  RF  group, the overall lesion width was significantly wider and lesion gaps significantly fewer at the anterior‐superior segment of the left  PV  ( LAS ) and anterior‐inferior segment of the right  PV  ( RAI ) in the  CB  group (lesion width: 8.2 ± 2.2 mm vs 5.6 ± 2.0 mm,  P  = .001; lesion gap at  LAS : 7% vs 38%,  P  = .02; lesion gap at  RAI : 7% vs 46%,  P  = .006).    Conclusions  The  PVI  lesions after  CB  ablation were characterized by extremely wider and more continuous lesions than those after  RF  ablation.

The lesion characteristics assessed by LGE ‐ MRI after the cryoballoon ablation and conventional radiofrequency ablation