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PVAC ablation

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https://www.readbyqxmd.com/read/29016870/complications-of-pulmonary-vein-isolation-in-atrial-fibrillation-predictors-and-comparison-between-four-different-ablation-techniques-results-from-the-middelheim-pvi-registry
#1
Yves De Greef, Edwin Ströker, Bruno Schwagten, Kaspars Kupics, Jeroen De Cocker, Gian-Battista Chierchia, Carlo de Asmundis, Dirk Stockman, Ian Buysschaert
Aims: To define predictors of complications of pulmonary vein isolation (PVI) and compare safety between different ablation techniques. Methods and results: One thousand patients with atrial fibrillation (AF) (age 60 ± 10, 72% males, CHA2DS2-VASc score 1 ± 1) underwent PVI using various techniques: conventional PVI (CPVI) using mapping with irrigated point-per-point RF ablation (n = 576), multi-electrode RF ablation with the pulmonary vein ablation catheter (PVAC) (n = 272) or high density mesh ablator (HDMA) (n = 59) and cryoballoon (CB) ablation (n = 93)...
August 3, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28875448/clinical-outcomes-of-af-patients-treated-with-the-first-and-second-generation-of-circular-mapping-and-ablation-catheter-insights-from-a-real-world-multicenter-experience
#2
Giovanni Rovaris, Paolo De Filippo, Francesco Laurenzi, Gabriele Zanotto, Nicola Bottoni, Mattia Pozzi, Fabrizio Giofrè, Piergiuseppe De Girolamo, Emanuela Visentin, Elena Piazzi, Paola Ferrari
PURPOSE: Complete pulmonary vein isolation (PVI) is the best documented target for catheter ablation, and different technologies have shown comparable outcomes. The multielectrode phased-RF/duty cycled (PhRF/DC) pulmonary vein ablation catheter (PVAC) and its second generation (PVAC-GOLD) have shown promising clinical results in single and multicenter experiences. Our aim is to assess and compare the safety and efficacy in the real clinical practice among two generations of circular PhRF/DC catheters by performing PVI in patients suffering from recurrent atrial fibrillation (AF)...
September 5, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28496936/strategies-to-improve-safety-and-efficacy-of-atrial-fibrillation-ablation-using-electrode-multipolar-phased-rf-pvac%C3%A2-catheter-a-case-report
#3
Fabio Dorfman, Cristiano Dietrich, Paulo Costa, Evandro Sbaraini, Rafael Abt, Dalmo Moreira, Cézar Mesas
Phased radiofrequency ablation with a single catheter technique, using a 9-electrode circumferential catheter, is a viable approach to pulmonary vein isolation for the treatment of atrial fibrillation. However, creating effective transmural lesions with such technique, while avoiding serious complications like atrioesophageal fistula, can be difficult. This case illustrates a challenging scenario, where catheter maneuvers fail to allow safe radiofrequency delivery, due to esophageal temperature rise, despite extensive navigating maneuvers...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28427852/circumferential-pulmonary-vein-isolation-with-second-generation-multipolar-catheter-in-patients-with-paroxysmal-or-persistent-atrial-fibrillation-procedural-and-one-year-follow-up-results
#4
Stefan G Spitzer, Patrick Leitz, Anke Langbein, Laszlo Karolyi, Frank Scharfe, Thomas Weinmann, Carola Rämmler, Christian Pott, Gerold Mönnig, Lars Eckardt
BACKGROUND: There is a lack of procedural and follow-up data on pulmonary vein isolation (PVI) with the second-generation pulmonary vein ablation catheter® (PVAC Gold) in patients with atrial fibrillation (AF). This study provides data on PVI procedures and 1-year follow-up results with PVAC Gold in patients with AF treated in clinical practice. METHODS AND RESULTS: Three hundred and eighty four patients with documented symptomatic paroxysmal (n=198) or persistent (n=186) AF were included in a non-randomized prospectively designed database...
April 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28424659/online-measurement-of-microembolic-signal-burden-by-transcranial-doppler-during-catheter-ablation-for-atrial-fibrillation-results-of-a-multicenter-trial
#5
Christian von Bary, Thomas Deneke, Thomas Arentz, Anja Schade, Heiko Lehrmann, Sabine Fredersdorf, Dobri Baldaranov, Lars Maier, Felix Schlachetzki
INTRODUCTION: Left atrial pulmonary vein isolation (PVI) is an accepted treatment option for patients with symptomatic atrial fibrillation (AF). This procedure can be complicated by stroke or silent cerebral embolism. Online measurement of microembolic signals (MESs) by transcranial Doppler (TCD) may be useful for characterizing thromboembolic burden during PVI. In this prospective multicenter trial, we investigated the burden, characteristics, and composition of MES during left atrial catheter ablation using a variety of catheter technologies...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28281739/cerebral-micro-embolization-during-pulmonary-vein-isolation-relation-to-post-ablation-silent-cerebral-ischemia
#6
Edina Nagy-Baló, Mihran Martirosyan, Gábor Sándorfi, Orsolya Hajas, Levente Lánczi, Ervin Berényi, Lilla Ladányi, Alexandra Kiss, István Édes, Zoltán Csanádi
BACKGROUND: High incidences of silent cerebral ischemia (SCI) have been revealed by diffusion-weighted magnetic resonance imaging (DW MRI) after pulmonary vein isolation (PVI) for atrial fibrillation. A high number of mostly gaseous micro-embolic signals (MESs) was detected by transcranial Doppler (TCD) during PVI. In this investigation the possible relationship between MESs detected intraoperatively by TCD and new SCI on DW MRI post-ablation is reported. METHODS: 27 consecutive atrial fibrillation patients (6 female, age median: 64 interquartile range: 13...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/27909499/hyperacute-and-chronic-changes-in-cerebral-magnetic-resonance-images-after-pvac-nmarq-and-epicardial-thoracoscopic-surgical-ablation-for-paroxysmal-atrial-fibrillation
#7
Conn Sugihara, Neil Barlow, Emma Owens, David Sallomi, Neil Sulke
Threshold testing of cardiac rhythm devices is essential to monitoring the proper functioning of such devices (1). However, the currently method of applying multiple ECG leads to the patient is burdensome and time consuming (2). We are presenting a completely new way to perform cardiac rhythm device threshold testing using pulse oximetry. Twenty patients, with varying cardiac rhythm devices and pacing modes, were enrolled and had their atrial and ventricular thresholds tested. A comparison was made between simultaneous threshold determinations via the standard EGM based method and the new pulse oximetry based method...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27878420/a-5-year-clinical-follow-up-after-duty-cycled-phased-rf-ablation-of-paroxysmal-atrial-fibrillation
#8
Antoine Lepillier, Xavier Copie, Gilles Lascault, Olivier Paziaud, Olivier Piot
PURPOSE: Catheter radiofrequency ablation (RFA) is an effective treatment for symptomatic paroxysmal atrial fibrillation (AF). It has been demonstrated that the multielectrode pulmonary vein ablation catheter (PVAC) has favourable outcomes at 6-12 months post-ablation, but there are only few studies with a long-term follow-up. METHODS: We retrospectively reviewed 77 consecutive PVAC procedures in our centre, from November 2007 to December 2012. RFA was attempted in patients with symptomatic paroxysmal AF (mean age 58...
November 22, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/27752967/effective-contact-and-outcome-after-pulmonary-vein-isolation-in%C3%A2-novel%C3%A2-circular-multi-electrode-atrial-fibrillation-ablation
#9
P Gal, T J Buist, J J J Smit, A Adiyaman, A R Ramdat Misier, P P H M Delnoy, A Elvan
INTRODUCTION: Pulmonary vein (PV) reconnection is frequently the cause of recurrence of atrial fibrillation (AF) after ablation. The second-generation gold multi-electrode ablation (Gold-MEA) catheter has a new design possibly resulting in improved lesion formation compared with its predecessor. We aimed to determine the association between effective radiofrequency applications with the Gold-MEA catheter and outcome after AF ablation. METHODS: 50 consecutive patients with paroxysmal AF underwent Gold-MEA (PVAC GOLD(TM), Medtronic Inc...
January 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27327662/influence-of-clinical-parameters-and-anticoagulation-on-intraprocedural-cerebral-microembolic-signals-during-pulmonary-vein-isolation
#10
Robert Larbig, Ralf Dittrich, Simon Kochhaeuser, Patrick Leitz, Fatih Guener, Catharina Korsukewitz, Dirk Dechering, Christian Pott, Kristina Wasmer, Jan Schmitges, Monika Kerckhoff, Lars Eckardt, Gerold Moennig
OBJECTIVE: We had the objective to determine the impact of clinical parameters and anticoagulation status on cerebral microembolic signals (MES) during pulmonary vein isolation (PVI) for atrial fibrillation (AF). BACKGROUND: Thromboembolism and stroke are the most feared complications of PVI. MES can help to evaluate embolic burden. It is unknown whether clinical parameters have an impact on embolic risk during PVI. METHODS: In this retrospective analysis we investigated the impact of clinical parameters, including the CHADS2- and CHA2DS2-VASc-score, pulmonary vein variants and echocardiographic parameters on MES rates in patients that underwent PVI using three different ablation approaches (radiofrequency ablation (iRF), pulmonary vein ablation catheter (PVAC) with deactivated electrode pair 1 or 5 (PVAC-red) or PVAC without deactivation (PVAC-all)...
2016: PloS One
https://www.readbyqxmd.com/read/27230934/first-results-and-follow-up-of-a-second-generation-circular-mapping-and-ablation-catheter
#11
Stefan Weber, Martin Höher, Dominik Schultes
PURPOSE: Pulmonary vein isolation with radiofrequency energy is widely used as a strategy for catheter ablation of atrial fibrillation (AF). Anatomically designed catheters have been developed to increase the efficiency of AF ablation procedures. The second-generation circular ablation catheter, PVAC GOLD, was re-designed to improve energy delivery and mitigate emboli. We investigated the procedural efficiency, biophysics, and chronic efficacy of PVAC GOLD in patients with AF. METHODS: We consecutively enrolled 40 patients (60 ± 11 years) with highly symptomatic, drug refractory AF...
November 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/27220967/spatial-distribution-of-electrical-reconnection-after-pulmonary-vein-isolation-in-patients-with-recurrent-paroxysmal-atrial-fibrillation
#12
L M Rademakers, I Romero, T A Simmers, P H van der Voort, A M Meijer, L R Dekker
INTRODUCTION: Recurrence of atrial fibrillation after pulmonary vein isolation (PVI) occurs frequently and may be associated with electrical reconnection of the pulmonary veins (PV). We investigated spatial distribution of electrical reconnection during re-do procedures in patients with paroxysmal atrial fibrillation who had previous successful acute electrical PVI with either single irrigated tip, antral ablation (s-RF; n = 38) or multi-electrode, duty-cycled ablation (PVAC; n = 48)...
July 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/26921762/predictability-of-lesion-durability-for-af-ablation-using-phased-radiofrequency-power-temperature-and-duration-impact-creation-of-transmural-lesions
#13
Mélèze Hocini, Cathy Condie, Mark T Stewart, Nicole Kirchhof, Jason D Foell
BACKGROUND: Long-term clinical outcomes for atrial fibrillation ablation depend on the creation of durable transmural lesions during pulmonary vein isolation and on substrate modification. Focal conventional radiofrequency (RF) ablation studies have demonstrated that tissue temperature and power are important factors for lesion formation. However, the impact and predictability of temperature and power on contiguous, transmural lesion formation with a phased RF system has not been described...
July 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/26921761/lower-rate-of-left-atrial-tachycardia-after-pulmonary-vein-isolation-with-pvac-versus-irrigated-tip-circumferential-antral-ablation
#14
Kristina Wasmer, David Krüsemann, Patrick Leitz, Fatih Güner, Christian Pott, Stephan Zellerhoff, Dirk Dechering, Julia Köbe, Philipp S Lange, Lars Eckardt, Gerold Mönnig
BACKGROUND: Left atrial tachycardias (LAT) occur in about 5% of patients after irrigated-tip circumferential antral (CA) pulmonary vein isolation (PVI). They may cause debilitating symptoms in the patient and may be very difficult to treat. OBJECTIVE: To assess the incidence of LAT after PVI with the multielectrode phased-radiofrequency pulmonary vein ablation catheter (PVAC) compared to circumferential antral PVI with an irrigated-tip catheter. METHODS: We analyzed data from our ablation database...
August 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/26644279/esophageal-and-mediastinal-lesions-following-multielectrode-duty-cycled-radiofrequency-pulmonary-vein-isolation-simple-equals-safe
#15
Stephan Zellerhoff, Frank Lenze, Hansjörg Ullerich, Alex Bittner, Kristina Wasmer, Julia Köbe, Christian Pott, Lars Eckardt, Gerold Mönnig
BACKGROUND: The development of esophageal lesions following atrial fibrillation (AF) ablation has frequently been reported. Mediastinal tissue layers and the posterior wall of the left atrium are in close proximity to the site of ablation. Hence, mucosal lesions might solely represent the "tip of the iceberg." We therefore investigated patients undergoing multielectrode phased radiofrequency (RF) ablation (PVAC®, Medtronic Inc., Minneapolis, MN, USA) for symptomatic AF by radial endosonography (EUS) in conjunction with conventional endoscopy esophago-gastro-duodenoscopy (EGD) to visualize potential mediastinal injuries following pulmonary vein isolation (PVI)...
April 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/26552799/site-localization-of-painful-lesions-during-radiofrequency-ablation-of-pulmonary-veins-using-circular-multi-electrode-catheters
#16
Avishag Laish-Farkash, Amos Katz, Ornit Cohen, Azriel Osherov, Sharon Bruocha, Vladimir Khalameizer
PURPOSE: Previous data showed that pain sensation was common during pulmonary vein isolation (PVI) using an 8-mm radiofrequency (RF) ablation catheter. Pain was more common in the left pulmonary veins (PVs). We characterized the location of pain during PVI using circular multi-electrode ablation catheters. METHODS: Included are all consecutive patients with atrial fibrillation (AF) who underwent PVI using the phased RF PVAC® catheter (Medtronic) or the irrigated nMARQ™ catheter (Biosense Webster) under conscious sedation between July 2011 and March 2015...
January 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/26310300/phased-multipolar-radiofrequency-pulmonary-vein-isolation-is-as-effective-and-safe-as-conventional-irrigated-point-to-point-ablation-a-prospective-randomised-1-year-implantable-cardiac-monitoring-device-follow-up-trial
#17
RANDOMIZED CONTROLLED TRIAL
S J Podd, A N Sulke, C Sugihara, S S Furniss
PURPOSE: Pulmonary vein isolation (PVI) is conventionally performed using 3D electroanatomical mapping to guide point-to-point ablation. The Pulmonary Vein Ablation Catheter (PVAC)® is a phased multipolar ablation (PMRA) catheter designed for rapid PVI using radiological anatomical information. Comparison of these methods of PVI using continuous beat-to-beat monitoring was undertaken. METHODS: Fifty patients with drug-refractory, symptomatic paroxysmal atrial fibrillation (PAF) were recruited...
December 2015: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/26081432/pulmonary-vein-stenosis-after-pulmonary-vein-isolation-using-duty-cycled-unipolar-bipolar-radiofrequency-ablation-guided-by-intracardiac-echocardiography
#18
Stefan Asbach, Fabienne Schluermann, Luca Trolese, Mathias Langer, Christoph Bode, Tobias Krauss
PURPOSE: Concerning rates of pulmonary vein (PV) stenosis were reported following PV isolation (PVI) with a circular pulmonary vein ablation catheter (PVAC). As this may depend on intraprocedural imaging, we evaluated the incidence of PV stenosis in patients undergoing PVAC-PVI with continuous surveillance by intracardiac echocardiography (ICE). METHODS: Multi-slice computed tomography was performed before and 3 months after PVAC-PVI with continuous ICE surveillance in 30 patients (37 % male, 65 ± 9 years)...
October 2015: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/25921346/silent-cerebral-events-as-a-result-of-left-atrial-catheter-ablation-do-not-cause-neuropsychological-sequelae-a-mri-controlled-multicenter-study
#19
MULTICENTER STUDY
Christian von Bary, Thomas Deneke, Thomas Arentz, Anja Schade, Heiko Lehrmann, Christoph Eissnert, Susanne Schwab-Malek, Sabine Fredersdorf, Ekrem Ücer, Dobri Baldaranov, Christina Wendl, Felix Schlachetzki
PURPOSE: Recently, diffusion-weighted magnetic resonance imaging (DW-MRI) revealed silent cerebral events (SCEs) as an acute complication of pulmonary vein isolation (PVI). We investigated whether SCEs following PVI are associated with neuropsychological deficits observed during patients' follow-up examinations. METHODS: After PVI, 52 patients were eligible for follow-up. PVI was performed using a variety of ablation technologies (duty-cycled phased radiofrequency (RF) multipolar ablation with the Pulmonary Vein Ablation Catheter® (PVAC) in 24 patients, cooled-tip RF ablation in 23 patients, and cryoballoon ablation in five patients)...
September 2015: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/25883082/safety-profile-of-multielectrode-phased-radiofrequency-pulmonary-vein-ablation-catheter-and-irrigated-radiofrequency-catheter
#20
COMPARATIVE STUDY
K Wasmer, P Foraita, P Leitz, F Güner, C Pott, P S Lange, L Eckardt, G Mönnig
BACKGROUND: Silent cerebral lesions with the multielectrode-phased radiofrequency (RF) pulmonary vein ablation catheter (PVAC(®)) have recently been investigated. However, comparative data on safety in relation to irrigated RF ablation are missing. METHODS AND RESULTS: One hundred and fifty consecutive patients (58 ± 12 years, 56 female) underwent first pulmonary vein isolation (PVI) for atrial fibrillation (61% paroxysmal) using PVAC(®) (PVAC). Procedure data as well as in-hospital complications were compared with 300 matched patients who underwent PVI using irrigated RF (iRF)...
January 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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