Current evidence on the efficacy and safety of percutaneous balloon cryoablation for pulmonary vein isolation in atrial fibrillation is adequate to support the use of this procedure provided that normal arrangements are in place for clinical governance, consent and audit.
Patient selection and treatment should only be carried out by interventional cardiologists with expertise in electrophysiology and complex ablation procedures.
This procedure should be carried out only in units with arrangements for emergency cardiac surgical support in case of complications.
Clinicians should enter details about all patients undergoing percutaneous balloon cryoablation for pulmonary vein isolation in atrial fibrillation onto the UK Central Cardiac Audit Database (UKCCAD) run by the National Institute for Cardiovascular Outcomes Research.
NICE encourages clinicians to enter patients into research studies with the particular aims of guiding selection of patients and of defining the place of percutaneous balloon cryoablation in relation to other procedures for treating atrial fibrillation. Further research should define patient selection criteria clearly and should document adverse events and long-term control of atrial fibrillation.