OBJECTIVES: Pulmoanry vein isolation using cryoablation represents a recently developed technology for atrial fibrillation management. Its safety and efficacy need to be evaluated. METHODS: From February 2011 to December  2012, 58 patients underwent pulmonary veins isolation by cryoablation with Arctic Front Cryoballoon (40 men and 15 women) with a mean age of 64.2 ± 11.3 years (range 44-71), symptomatic paroxysmal atrial fibrillation refractory to medical therapy and at least two antiarrhythmic drugs. In 12 patients (20.6%) there was a normal left atrial diameter, while in the remaining 36 (79.4%)there was a documented mild to moderate dilatation (mean diameter 50 mm). The ejection fraction (EF) measured by echocardiography was normal in 47 patients (81%, mean FE 58.3%), while in 11 patients (19%) there was a moderate left ventricular dysfunction (mean EF 43 %).  76% of patients underwent 2 cryo applications for pulmonary vein, while in the remaining 24% of patients was not  possible the cannulation of the lower right pulmonary vein for technical-anatomical reasons. We performed a clinical follow-up at 3 and 6 months with 24h Holter ECG (27 pts) and subcutaneous implant of Loop Recorder (28 pts). RESULTS: At the end of follow-up: 51 patients (87.9%) were asymptomatic for palpitations and in sinus rhythm, 4 patients (6.9%) went to the emergency department for palpitations with electrocardiographic evidence of typical atrial flutter and underwent SVC-tricuspid isthmus ablation and 3 patients (5.21%) experienced episodes of AF lasting less than 24 hours. CONCLUSIONS: The isolation of  pulmonary veins ostium by cryoablation with Arctic Front Cryoballoon in our series is a safe and effective technique with a low incidence of recurrence of the arrhythmia in the short term