ABC | Volume 110, Nº5, May 2018

Original Article Chen et al PV anatomy and cryo kinetics Arq Bras Cardiol. 2018; 110(5):440-448 Figure 3 – Scatterplot of PV ostium corrected diameters and balloon nadir temperature using two sizes of cryoballoon. Balloon Type: 23-mm Balloon Type: 28-mm R 2 Linear = 0.264 R 2 Linear = 0.100 –40 –40 –35 –45 –45 –50 –50 –55 –55 –60 –60 –65 –65 10 10 15 15 20 20 30 25 25 35 Corrected Diameters of PV Ostium (mm) Corrected Diameters of PV Ostium (mm) Balloon Nadir Temperature (°C) Balloon Nadir Temperature (°C) Table 3 – Proportion of PV drainage patterns Location typical with common trunk with common antrum with ostial branch with supernumerary vein (MPV) LSPV 23(38.3) 11(18.3) 25(41.7) 2(3.3) 0 LIPV 23(38.3) 11(18.3) 25(41.7) 3(5.0) 0 RIPV 24(40) 0 6(10) 27(45) 4(6.7) RSPV 37(61.7) 0 6(10) 14(23.3) 4(6.7) Total 107(44.6) 22(9.2) 62(25.8) 46(19.2) 8(3.3) Values are n (%). MPV: middle pulmonary vein; LSPV: left superior pulmonary vein; LSPV: left superior pulmonary vein; LIPV: left inferior pulmonary vein; RIPV: right inferior pulmonary vein; RSPV: right superior pulmonary vein. Table 4 – Parameters of cryo kinetics PV location BFT (s) BNT (°C) BWT (s) 23-mm CB 28-mm CB p 23-mm CB 28-mm CB p 23-mm CB 28-mm CB p LSPV 13.7 ± 4.2 23.8 ± 9.1 < 0.001 -52.8 ± 6.5 -46.8 ± 7.1 < 0.001 19.8 ± 7.7 25.3 ± 11.0 0.001 LIPV 14.5 ± 3.4 27.3 ± 7.8 < 0.001 -50.2 ± 4.9 -42.0 ± 4.8 < 0.001 17.5 ± 5.7 17.9 ± 5.9 0.656 RIPV 13.9 ± 4.0 28.1 ± 8.9 < 0.001 -52.6 ± 5.9 -42.3 ± 6.9 < 0.001 20.0 ± 7.6 18.4 ± 8.4 0.237 RSPV 12.1 ± 3.0 21.3 ± 7.6 < 0.001 -56.8 ± 5.1 -49.7 ± 6.7 < 0.001 26.0 ± 6.8 30.4 ± 11.5 0.008 Total 13.6 ± 3.8 25.2 ± 8.8 < 0.001 -53.1 ± 6.1 -45.1 ± 7.1 < 0.001 20.8 ± 7.6 22.7 ± 10.6 0.014 Values are mean ± SD. p: p-value (unpaired Student’s t-test). CB: cryoballoon; BFT: balloon freezing time from 0 to -30°C; BNT: balloon nadir temperature; BWT: balloon warming time from -30 to +15°C; LSPV: left superior pulmonary vein; LIPV: left inferior pulmonary vein; RIPV: right inferior pulmonary vein; RSPV: right superior pulmonary vein. and could deform to adapt to the CB during procedure; (2) Different definitions of PV ostium shape and drainage pattern between studies; (3) cryo kinetic effect is associated with but not equal to occlusion degree or ablation effect. Compared with 23-mm CB, the association between BNT and D corrected was weaker when using the 28-mm CB. This may be because: (1) 28-mm CB had a higher requirement for PV compliance and “free space” to handle (e.g., PV location, puncturing site of interatrial septum); (2) PV ablated using the 28-mm CB had a smaller ratio of D corrected and diameter of CB in this study, which limited the comparability. Efficacy and safety of two CB sizes Some studies reported that 23-mm CBs was associated with higher success rates but came at the cost of safety, referring mainly to the complication of PN palsy. 15,17,18 445