A 62-year-old man with a history of symptomatic resistant paroxysmal atrial fibrillation (AF) underwent percutaneous pulmonary vein (PV) isolation with a 28 mm diameter cryoballoon catheter (Arctic Front ^® ; Medtronic CryoCath LP, Pointe-Claire, QC, Canada). A 20 mm circular loop mapping catheter with eight evenly spaced electrodes (Achieve ^® ; Medtronic, Minneapolis, MN, USA) was used. This wire is especially designed to combine appropriate positioning of the cryoballoon at the PV antrum and visualization of PV potentials throughout cryoablation ( Fig. 1 A ).

A. Fluoroscopic image (front view) showing complete occlusion of the left inferior pulmonary vein (LIPV) using a cryoballoon and a mapping catheter advanced into the pulmonary vein. A quadripolar catheter is positioned in the superior vena cava (SVC) and a decapolar catheter is positioned in the coronary sinus (CS). An oesophageal temperature probe is also visible close to the balloon. B. Temperature curve during application of cryotherapy.

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