Study results according to the application duration.

A) Details of the freezing and B) lesion size. * statistically significant, ** marginally significant.</p

Schematic representation of this experimental study.

A) Ex-vivo setup, B) push-up technique, and C) lesion measurements.</p

Study results.

ObjectiveThe frozen lesion formation created by cryoballoon ablation, especially with non-occluded applications, has not been fully evaluated. This study aimed to validate the lesion size under different cryoballoon ablation settings: application duration, push-up technique, and laminar flow.MethodsThe frozen lesion size was evaluated immediately after ending the freezing with three different application durations (120, 150, and 180 seconds) in porcine hearts (N = 24). During the application, the push-up technique was applied at 10, 20, and 30 seconds after starting the freezing with or without laminar flow.ResultsThe lesion size was significantly correlated with the nadir balloon temperature (P3 versus 1709mm3, P = 0.004), but not after 150 seconds (versus 1876mm3 at 180 seconds, P = 0.29) with a comparable nadir balloon temperature. Furthermore, the lesion volume became significantly larger with the push-up technique with the largest lesion size with a 20-second push-up after the freezing (1193mm3 without the push-up technique versus 1585mm3 with a push-up at 10 seconds versus 1808mm3 with a push-up at 20 seconds versus 1714mm3 with a push-up at 30 seconds, P = 0.04). Further, the absence of laminar flow was not associated with larger lesion size despite a significantly lower nadir balloon temperature.ConclusionThe frozen lesion size created by cryoballoon ablation became larger with longer applications at least 150 seconds and with a push-up technique especially at 20 seconds after the freezing.</div

Correlations between the lesion size and nadir balloon temperature.

Correlations between the lesion size and nadir balloon temperature.</p

Study results according to the laminar flow.

A) Details of the freezing and B) lesion size. * statistically significant, ** marginally significant.</p

Supplemental materials.

ObjectiveThe frozen lesion formation created by cryoballoon ablation, especially with non-occluded applications, has not been fully evaluated. This study aimed to validate the lesion size under different cryoballoon ablation settings: application duration, push-up technique, and laminar flow.MethodsThe frozen lesion size was evaluated immediately after ending the freezing with three different application durations (120, 150, and 180 seconds) in porcine hearts (N = 24). During the application, the push-up technique was applied at 10, 20, and 30 seconds after starting the freezing with or without laminar flow.ResultsThe lesion size was significantly correlated with the nadir balloon temperature (P3 versus 1709mm3, P = 0.004), but not after 150 seconds (versus 1876mm3 at 180 seconds, P = 0.29) with a comparable nadir balloon temperature. Furthermore, the lesion volume became significantly larger with the push-up technique with the largest lesion size with a 20-second push-up after the freezing (1193mm3 without the push-up technique versus 1585mm3 with a push-up at 10 seconds versus 1808mm3 with a push-up at 20 seconds versus 1714mm3 with a push-up at 30 seconds, P = 0.04). Further, the absence of laminar flow was not associated with larger lesion size despite a significantly lower nadir balloon temperature.ConclusionThe frozen lesion size created by cryoballoon ablation became larger with longer applications at least 150 seconds and with a push-up technique especially at 20 seconds after the freezing.</div

Study results according to the push-up technique.

A) Details of the freezing and B) lesion size. * statistically significant, ** marginally significant.</p

Subgroup analyses for the primary outcome measure (death/MI/stroke).

Subgroup analyses for the primary outcome measure (death/MI/stroke).</p

Fig 2 -

Crude kaplan-meier curves for the cumulative incidence of (A) all-cause death/MI/stroke, (B) all-cause death, (C) any coronary revascularization, and (D) all-cause death/MI/stroke/any coronary revascularization. PCI = percutaneous coronary intervention; CABG = coronary artery bypass grafting; MI = myocardial infarction.</p

Angiographic and procedural characteristics: PCI group versus CABG group.

Angiographic and procedural characteristics: PCI group versus CABG group.</p