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Cryo balloon

Roy M John, Sunil Kapur, Kenneth A Ellenbogen, Jayanthi N Koneru
BACKGROUND: Collateral damage has been reported with use of the cryoballoon for pulmonary vein isolation. OBJECTIVE: The purpose of this study was to determine the incidence and characteristics associated with atrioesophageal fistula (AEF) after cryoballoon use. METHODS: Cases of AEF reported with use of the cryoballoon since 2011 were collected from the Manufacturer and User Facility Device Experience (MAUDE) database, publications, and the manufacturer's database...
October 18, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Arash Aryana, Marcin Kowalski, Padraig Gearoid O'Neill, Charles H Koo, Hae W Lim, Asif Khan, Robert B Hokanson, Mark R Bowers, David N Kenigsberg, Kenneth A Ellenbogen
BACKGROUND: Limited data exist on cryoablation of atrial fibrillation (Cryo-AF) using the newly available third-generation (Arctic Front Advance-Short Tip [AFA-ST]) cryoballoon. OBJECTIVE: In this multicenter study, we evaluated the safety and efficacy of Cryo-AF using the AFA-ST vs the second-generation (Arctic Front Advance [AFA]) cryoballoon. METHODS: We examined the procedural safety and efficacy and the short- and long-term clinical outcomes associated with a first-time Cryo-AF performed in 355 consecutive patients (254/355 [72%] with paroxysmal AF), using either the AFA-ST (n = 102) or the AFA (n = 253) cryoballoon catheters...
December 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Kunihiko Kiuchi, Koji Fukuzawa, Akinori Matsumoto
The impact of a cryoballoon ablation is reported to be similar to that of a radiofrequency (RF) ablation in patients with atrial fibrillation. Delayed enhancement magnetic resonance imaging (DE-MRI) could visualize the scar region induced by the cryoballoon ablation as well as RF ablation. Cryoballoon ablation could induce extensive scar lesions around the PVs. However, the distribution of the scar lesions after the cryoballoon ablation has not been well discussed. We, herein, described a case with an eccentric scar distribution after cryoballoon ablation...
June 2016: Journal of Arrhythmia
Tanja Kurzendorfer, Philip W Mewes, Andreas Maier, Norbert Strobel, Alexander Brost
Cryo-balloon catheters have attracted an increasing amount of interest in the medical community as they can reduce patient risk during left atrial pulmonary vein ablation procedures. As cryo-balloon catheters are not equipped with electrodes, they cannot be localized automatically by electro-anatomical mapping systems. As a consequence, X-ray fluoroscopy has remained an important means for guidance during the procedure. Most recently, image guidance methods for fluoroscopy-based procedures have been proposed, but they provide only limited support for cryo-balloon catheters and require significant user interaction...
August 2016: IEEE Transactions on Medical Imaging
Eugene G Kholmovski, Nicolas Coulombe, Joshua Silvernagel, Nathan Angel, Dennis Parker, Rob Macleod, Nassir Marrouche, Ravi Ranjan
INTRODUCTION: MRI-based ablation provides an attractive capability of seeing ablation-related tissue changes in real time. Here we describe a real-time MRI-based cardiac cryo-ablation system. METHODS: Studies were performed in canine model (n = 4) using MR-compatible cryo-ablation devices built for animal use: focal cryo-catheter with 8 mm tip and 28 mm diameter cryo-balloon. The main steps of MRI-guided cardiac cryo-ablation procedure (real-time navigation, confirmation of tip-tissue contact, confirmation of vessel occlusion, real-time monitoring of a freeze zone formation, and intra-procedural assessment of lesions) were validated in a 3 Tesla clinical MRI scanner...
May 2016: Journal of Cardiovascular Electrophysiology
Andreas Metzner, Erik Wissner, Tina Lin, Feifan Ouyang, Karl-Heinz Kuck
Ablation of atrial fibrillation (AF) is an established treatment option for symptomatic patients refractory to antiarrhythmic medication. In patients with paroxysmal AF, ablation can be offered as first-line therapy when performed in an experienced centre. The accepted cornerstone for all ablation strategies is isolation of the pulmonary veins. However, it is still challenging to achieve contiguous, transmural, permanent lesions using radio-frequency current (RFC) based catheters in conjunction with a three-dimensional mapping system and the learning curve remains long...
May 2015: Arrhythmia & Electrophysiology Review
Alexey Tsyganov, Jan Petru, Jan Skoda, Lucie Sediva, Pavel Hala, Jiri Weichet, Marek Janotka, Milan Chovanec, Petr Neuzil, Vivek Y Reddy
PURPOSE: We evaluated the correlation between pulmonary venous (PV) anatomy and acute and long-term success of PV isolation (PVI) with two balloon-based ablation catheter techniques. METHODS: One hundred consecutive patients were analyzed in two equal groups treated with either the second-generation cryoballoon (CRYO) catheter or the visually guided laser ablation (VGLA) catheter. All patients underwent multi-detector computed tomography (CT) imaging. The primary and secondary efficacy endpoints were the procedural achievement of proven electrical isolation of all veins and freedom from atrial fibrillation (AF) within a 1-year follow-up period, respectively...
December 2015: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Tolga Aksu, Sukriye Ebru Golcuk, Tümer Erdem Guler, Kivanç Yalin, Ismail Erden
OBJECTIVE: High-sensitivity troponin I (hsTnI) assays lead to, among other things, improvement in the detection of myocardial injury and improved risk stratification of patients with atrial fibrillation (AF). The aim of this study was to investigate the association between post-procedure cardiac biomarkers and clinical outcome in patients undergoing cryo-balloon ablation (CA) for AF. METHODS: A total of 57 patients (mean age 55.1 ± 12.2 years, 50.9% female) with symptomatic paroxysmal AF underwent the CA procedure...
July 2015: Cardiovascular Journal of Africa
Arash Aryana, Shemsa Morkoch, Sean Bailey, Hae W Lim, Rahmani Sara, André d'Avila, P Gearoid O'Neill
PURPOSE: There is limited data available on the safety and efficacy of the second-generation cryoballoon (CB-2) for cryoablation of atrial fibrillation (Cryo-AF). We evaluated the procedural, biophysical, and clinical outcomes of Cryo-AF in a large patient cohort using CB-2 as compared with the first-generation cryoballoon (CB-1). METHODS: Three-hundred and forty consecutive patients undergoing Cryo-AF with CB-1 (n = 140) and CB-2 (n = 200) were retrospectively evaluated...
November 2014: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Maciej Wojcik, Sebastien Janin, Malte Kuniss, Alexander Berkowitsch, Damir Erkapic, Sergey Zaltsberg, Katherina Madlener, Andrzej Wysokinski, Christian W Hamm, Heinz F Pitschner, Thomas Neumann
INTRODUCTION AND OBJECTIVES: Several biomarkers have been used for evaluation and quantification of myocardial injury after effective ablation. We studied possible different thermal stability and usability of the proteins released by cardiac cells injured by different energy sources. METHODS: Firstly, we tested in vitro thermal stability of creatinine kinase (CK), myocardial bound creatinine kinase (CKMB), cardiac troponins I (cTnI) and cardiac troponins T (cTnT) in collected blood samples from 15 patients (pts) with confirmed ST-segment elevated myocardial infarction (STEMI)...
February 2011: Revista Española de Cardiología
Konstantinos Marmagkiolis, Abdul Hakeem, Nishit Choksi, Malek Al-Hawwas, Mohan Mallikarjuna Rao Edupuganti, Massoud A Leesar, Mehmet Cilingiroglu
BACKGROUND: Endovascular approach to superficial femoral artery (SFA) disease, the most common cause of symptomatic peripheral arterial disease, remains fraught with high failure rates. Newer devices including second-generation nitinol stents, drug-coated stents, drug-coated balloons, covered stents, cryo-therapy, LASER, and directional atherectomy have shown promising results. Clinical equipoise still persists regarding the optimal selection of devices, largely attributable to the different inclusion criteria, study population, length of lesions treated, definition of "patency" and "restenosis," and follow-up methods in the pivotal trials...
October 1, 2014: Catheterization and Cardiovascular Interventions
Cynthia M Rodenburg, Sylvia A McPherson, Charles L Turnbough, Terje Dokland
Bacillus anthracis and other pathogenic Bacillus species form spores that are surrounded by an exosporium, a balloon-like layer that acts as the outer permeability barrier of the spore and contributes to spore survival and virulence. The exosporium consists of a hair-like nap and a paracrystalline basal layer. The filaments of the nap are comprised of trimers of the collagen-like glycoprotein BclA, while the basal layer contains approximately 20 different proteins. One of these proteins, BxpB, forms tight complexes with BclA and is required for attachment of essentially all BclA filaments to the basal layer...
April 2014: Journal of Structural Biology
Oren Fruchter, Mordechai R Kramer
INTRODUCTION: Retrieval of aspirated foreign bodies (FB) by flexible bronchoscopy is challenging. Many types of ancillary equipment, including forceps, grasping claws, snares, balloon-tipped catheters and magnets, have been developed to allow FB extraction using flexible bronchoscopes. The ability to remove a FB by flexible cryoprobe (cryoextraction) depends on the cryoadhesive properties of the retrieved object, which in turn depends on its physical properties. OBJECTIVES: Our aim was to explore ex vivo on a lung model the cryoadhesive properties of various commonly aspirated objects...
April 2015: Clinical Respiratory Journal
Lutz Freitag, Kaid Darwiche
For all cases of tracheal obstructions surgery should be considered first. Interventional endoscopic procedures can provide immediate relief. Intraluminally growing tumors can be resected with laser, argon-plasma coagulation, an electrosurgical knife or cryo-probe. Photodynamic therapy of smaller tracheal tumors can be curative. Narrowing from intramural tumor growth or wall destruction requires internal splinting with an airway stent. Scar strictures can be dilated with balloons but the biotrauma may stimulate new scarring...
February 2014: Thoracic Surgery Clinics
Carina Carnlöf, Per Insulander, Mats Jensen-Urstad
AIM: Pulmonary vein isolation (PVI) is an established method for treatment of drug refractory atrial fibrillation. The aim of this study was to evaluate whether a more active regular supply of analgesic and sedative drugs reduces pain and discomfort. We also wanted to evaluate gender differences in pain perception and to compare standard radiofrequency (RF) with cryo balloon ablation (Cryo) from this perspective. METHODS: A total of 80 patients, 40 men, median age 58 (range 23-76) years, who underwent PVI under conscious sedation were studied...
February 2014: Scandinavian Cardiovascular Journal: SCJ
Larry R Glazerman
Until the 1980s, the only available definitive treatment for heavy menstrual bleeding (HMB) was hysterectomy, usually performed abdominally, and sometimes vaginally. Historically, multiple attempts to effect ablation of the endometrium were developed, including using steam and toxic chemicals, such as chloriquine. The advent of Nd-YAG laser endometrial ablation in the mid-1980s offered the first minimally invasive alternative to hysterectomy for the treatment of HMB. Nd-YAG ablation, however, was expensive, cumbersome, and difficult to learn; rollerball resectoscopic ablation was initially described by DeCherney in 1987, and soon overtook laser as the main method of ablation, although adoption continued to be limited because of the hysteroscopic skills necessary to perform the technique were not widely available...
September 2013: Surgical Technology International
George D Katritsis, George C M Siontis, Eleftherios Giazitzoglou, Nikolaos Fragakis, Demosthenes G Katritsis
BACKGROUND: Cardiac tamponade is the main complication of transseptal catheterization that is necessary for a variety of cardiac interventions and electrophysiology procedures. METHODS: A retrospective assessment of all consecutive procedures that required transseptal puncture by the same experienced operator (with already >100 previous trans-septal procedures) during the period 2000-2012 was performed. We recorded any puncture-related complications of pericardial effusion and cardiac tamponade (acute or delayed)...
October 15, 2013: International Journal of Cardiology
Mark G Davies, Javier E Anaya-Ayala
The complex pathophysiology response to injury of the lower-extremity arteries has prompted the development of several unique balloon technologies to overcome initial technical failures and short-term intimal hyperplasia. Cryoplasty alters the cellular and mechanical properties of the vessel wall during angioplasty. Cutting balloons incise the wall, preventing elastic recoil and allowing expansion of the lumen at a lower pressure, thus limiting barotrauma. Drug-eluting balloons actively transfer inhibitory compounds to the wall during the initial therapy, while brachytherapy balloons allow for localized delivery of radiation to inhibit the proliferative response seen after angioplasty...
April 2013: Methodist DeBakey Cardiovascular Journal
Stefano Bordignon, K R Julian Chun, Melanie Gunawardene, Alexander Fuernkranz, Verena Urban, Britta Schulte-Hahn, Bernd Nowak, Boris Schmidt
INTRODUCTION: Balloon catheters have been developed to facilitate pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF). We sought to compare the safety and efficacy of the cryoballoon (CB) and the laserballoon (LB) in a pilot study. METHODS AND RESULTS: One hundred and forty patients with drug-refractory PAF were prospectively allocated in a 1:1 fashion to undergo a PVI procedure with the 28 mm CB or the LB and were followed for 12 months using 3-day Holter ECG recording...
September 2013: Journal of Cardiovascular Electrophysiology
Shibu Mathew, Andreas Metzner, Feifan Ouyang, Karl-Heinz Kuck, Roland Richard Tilz
The gold standard in ablation of paroxysmal atrial fibrillation (PAF) is radiofrequency (RF) based point by point pulmonary vein isolation (PVI). In the majority of patients with PAF (80 %) PVI can restore stable SR even during long-term follow-up of up to 5 years. However multiple procedures are often required. Cryo-balloon based PVI is an established technique. Safety and efficacy are comparable to RF ablation. Due to the high success rates in patients with PAF and the progression rate to persistent atrial fibrillation (AF) an early intervention is recommended as implemented in the latest guidelines for AF treatment...
March 2013: Herzschrittmachertherapie & Elektrophysiologie
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