{"id":"3e127c5e141b","type":"article","url":"https://hartvaat.nl/2022/07/15/geindividualiseerde-versus-standaard-cryoballonablatie-bij-paroxysmaal-af/","title":"Geïndividualiseerde versus standaard cryoballonablatie bij paroxysmaal AF","title_en":"Individualized or fixed approach to pulmonary vein isolation utilizing the fourth-generation cryoballoon in patients with paroxysmal atrial fibrillation: the randomized INDI-FREEZE trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["cryoablatie"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euab305","source_url":"https://doi.org/10.1093/europace/euab305","authors":["Christian Hendrik Heeger","Sorin Stefan Popescu","Roza Saraei","Bettina Kirstein","Sascha Hatahet","Omar Samara","Anna Traub","Marcel Fehe","Gabriele D'Ambrosio","Ahmad Keelani","Michael Schlüter","Charlotte Eitel","Julia Vogler","Karl Heinz Kuck","Roland Richard Tilz"],"significance":6,"published":"2022-07-15","source_date":"2022-07-15","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/ritmecontrole-af/","https://hartvaat.nl/kennis/atriumfibrilleren/flecainide-en-propafenon/"],"congress":"","summary_en":"This randomized trial compared individualized cryoballoon dosing with a standardized freeze protocol for AF ablation, finding comparable outcomes and supporting both approaches as acceptable energy delivery strategies.","created":"2026-07-03T10:29:49Z","updated":"2026-07-03T13:28:56Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial vergeleek geïndividualiseerde cryoballon-dosering met een standaardprotocol bij paroxysmaal AF. Beide strategieën toonden vergelijkbare effectiviteit en veiligheid. Standaarddosering is voldoende effectief, wat de procedure kan vereenvoudigen.","abstract_original":"AIMS: Cryoballoon (CB) based pulmonary vein isolation (PVI) is a widely used technique for treatment of atrial fibrillation (AF); however the ideal energy dosing has not yet been standardized. This was a single-centre randomized clinical trial aiming at assessing the safety, acute efficacy, and clinical outcome of an individualized vs. a fixed CB ablation protocol using the fourth-generation CB (CB4) guided by pulmonary vein (PV) potential recordings and CB temperature. METHODS AND RESULTS: Patients were randomized in a 1:1 fashion to two different dosing protocols: INDI-FREEZE group (individualized protocol): freeze-cycle duration of time to effect plus 90 s or interruption of the freeze-cycle and repositioning CB if a CB temperature of -30°C was not within 40 s. Control group (fixed protocol): freeze-cycle duration of 180 s. No-bonus freeze-cycle was applied in either patient group. The primary endpoint was freedom from atrial tachyarrhythmia at 12 months. Secondary end points included procedural parameters and complications. A total of 100 patients with paroxysmal AF were prospectively enrolled. No difference was seen in the primary endpoint [INDI-FREEZE group: 38/47 (81%) vs. control group: 40/47, (85%), P = 0.583]. The total freezing time was significantly shorter in the INDI-FREEZE group (157 ± 56 s vs. 212 ± 83 s, P < 0.001), while procedure duration (57.9 ± 17.9 min vs. 63.2 ± 20.2 min, P = 0.172) was similar. No differences were seen in the minimum CB and oesophageal temperatures as well as in periprocedural complications. CONCLUSION: Compared to the fixed protocol, the individualized approach provides a similar safety profile and clinical outcome, while reducing the total freezing time."}