Impact of Expandable Cryoballoon on Pulmonary Vein Morphology and Treatment Selection in Atrial Fibrillation Ablation

After introduction of 31 mm CB, the proportion of patients selecting RFCA due to large PV size decreased from 30.7% to 8.3% (p < 0.01). Left and right superior PV were significantly larger and both left and right PV distance were significantly longer in the 31 mm CB group. The actual PVI lesion area was significantly larger in the 31 mm CB group (28 mm CB: 14.1 ± 3.4 cm², 31 mm CB: 17.5 ± 3.7 cm², p < 0.01). One-year atrial tachyarrhythmia recurrence was not significantly different between groups (p = 0.62) CONCLUSION: Despite inclusion of patients with larger PVs, the 31 mm CB was associated with a larger PVI lesion, with similar 1-year recurrence. The introduction of a 31 mm CB expanded CB eligibility and reduced the need for RFCA in the real-world practice.