Cryoballoon atrial fibrillation ablation experience in Japan

Purpose of review In Japan, cryoballoon ablation has been widely accepted and more than 70 000 patients have undergone pulmonary vein isolation using this novel technology since the introduction. This review focused on the current status of cryoballoon ablation in Japan and clarified the characteristics as compared to Europe and the United States. Recent findings The number of atrial fibrillation patients undergoing cryoballon ablation has rapidly increased over the last 6 years. Most of the Japanese physicians consider the indication of cryoballoon ablation based on the anatomy of the pulmonary veins and left atrium evaluated on preprocedural computed tomography, and often perform adjunctive radiofrequency ablation after the pulmonary vein isolation. The reported overall efficacy and safety were similar to that in Europe and the United States; however, there are some distinctive complications of the cryoballoon procedure in Japan, such as air embolisms, gastric hypomotility and coronary artery spasms. Summary Currently, the cryoballoon pulmonary vein isolation is widely accepted in Japan owing to the low incidence of lethal complications, shorter procedure time and acceptable single procedure atrial fibrillation freedom.