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Cryoballoon

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https://www.readbyqxmd.com/read/29326828/cryoballoon-ablation-in-today-s-practice-can-the-left-common-ostium-be-ablated-and-injury-to-the-right-phrenic-nerve-avoided
#1
Gian-Battista Chierchia, Saverio Iacopino, Carlo de Asmundis
Cryoballoon ablation is rapidly gaining popularity among electrophysiologists in the setting of pulmonary vein isolation for the treatment of AF. The first part of the following review focuses on the feasibility and clinical outcome of this technique in patients exhibiting a left common ostium. In the second part, we discuss how to predict and prevent the most common complication related to cryoballoon ablation: right phrenic nerve palsy.
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29324261/platelet-toll-like-receptor-and-its-ligand-hmgb-1-expression-is-increased-in-the-left-atrium-of-atrial-fibrillation-patients
#2
Kadri Murat Gurses, Duygu Kocyigit, Muhammed Ulvi Yalcin, Hande Canpinar, Banu Evranos, Ugur Canpolat, Hikmet Yorgun, Levent Sahiner, Dicle Guc, Kudret Aytemir
BACKGROUND: Atrial fibrillation(AF) is the most common sustained arrhythmia. Its most feared sequelae are stroke and peripheral thromboembolism due to atrial thrombi formation. Mechanisms underlying the relationship between platelet activation and left atrial thrombi have not been clearly elucidated yet. We aimed to investigate whether immune-mediated platelet activation occurred in AF patients in this cross-sectional study. METHODS: Persistent and paroxysmal AF patients who underwent cryoballoon-based AF ablation between March 2015 and July 2016 were included as the patient group...
January 8, 2018: Cytokine
https://www.readbyqxmd.com/read/29305676/impact-of-3d-mapping-on-procedural-characteristics-and-outcomes-in-cryoballoon-pulmonary-vein-isolation-for-atrial-fibrillation
#3
Emily N Guhl, Evan Adelstein, Andrew Voigt, Norman C Wang, Samir Saba, Sandeep K Jain
PURPOSE: The use of 3D mapping during cryoballoon pulmonary vein isolation (PVI) is optional with added cost but potential benefit in aiding vein identification, reducing fluoroscopy, and post-ablation testing. Data are limited evaluating procedural characteristics and outcomes in patients undergoing cryoballoon PVI with mapping vs. no mapping. In the present study, we compare procedural characteristics and recurrence-free rates in patients undergoing cryoballoon PVI among patients using CARTO®, NavX™, or no mapping system...
January 5, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29297907/-combined-left-atrial-appendage-percutaneous-closure-and-atrial-fibrillation-ablation-a-single-center-experience
#4
Elisa Pelissero, Marco Giuggia, Maria Chiara Todaro, Giuseppe Trapani, Benedetta Giordano, Gaetano Senatore
BACKGROUND: We evaluated long-term safety and efficacy of concomitant left atrial appendage (LAA) closure and atrial fibrillation (AF) ablation. METHODS: From February 2013 to June 2017, all patients referred for AF ablation and LAA closure (group 1) were enrolled in the study and compared with a matched control group undergoing AF ablation only (group 2). Pulmonary vein isolation was achieved in all cases with radiofrequency or cryoballoon. LAA was occluded with Watchman or Amplatzer Cardiac Plug or Amulet (ACP) devices...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29279459/does-size-matter-cryoballoon-based-pulmonary-vein-isolation-using-a-novel-25-mm-circular-mapping-catheter
#5
Bruno Reissmann, Michael Schlüter, Francesco Santoro, Tilman Maurer, Christian-Hendrik Heeger, Christine Lemes, Thomas Fink, Johannes Riedl, Andreas Rillig, Shibu Mathew, Feifan Ouyang, Karl-Heinz Kuck, Andreas Metzner
BACKGROUND: Real-time recording of pulmonary vein isolation (PVI) using a circular mapping catheter has become a key aspect of cryoballoon (CB) ablation. The aim of this study was to investigate the procedural safety, efficacy and rate of real-time pulmonary vein (PV) recording using a novel circular mapping catheter with a 25-mm loop size for CB-based PVI.Methods and Results:A total of 40 patients with symptomatic atrial fibrillation (AF) underwent PVI using a second-generation CB and a novel 25-mm circular mapping catheter...
December 27, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29250289/mechanistic-insights-into-durable-pulmonary-vein-isolation-achieved-by-second-generation-cryoballoon-ablation
#6
Yasuo Okumura, Ichiro Watanabe, Kazuki Iso, Keiko Takahashi, Koichi Nagashima, Kazumasa Sonoda, Hiroaki Mano, Naoko Yamaguchi, Rikitake Kogawa, Ryuta Watanabe, Masaru Arai, Kimie Ohkubo, Sayaka Kurokawa, Toshiko Nakai, Atsushi Hirayama
Background: The mechanism explaining the efficacy of cryoballoon ablation (CBA) for atrial fibrillation has not been clarified. Methods and Results: We compared lesion characteristics between patients in whom pulmonary vein isolation (PVI) was performed by CBA (n=56) and those by contact force (CF)-based RF ablation (n=56). We evaluated the 3-dimensional PV morphology before and after cryoballoon inflation. After PVI, a 3D left atrial voltage map was created. Pacing (10 mA and 2 ms) was performed within the low voltage area from the ablation line, and electrically unexcitable ablated tissue was identified...
April 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250269/bonus-vs-no-bonus-cryoballoon-isolation-for-paroxysmal-atrial-fibrillation-ablation
#7
Aysenur Ekizler, Dursun Aras, Serkan Cay, Ozcan Ozeke, Firat Ozcan, Serkan Topaloglu
Aims: To evaluate the benefit of Bonus freeze using second generation cryoballoon after pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF). Methods: A bonus freeze is performed after proven pulmonary vein isolation (PVI) for cryoballoon ablation of paroxysmal atrial fibrillation (PAF) as standard. In the current study, no additional freeze (No Bonus) after PVI was compared with additional freeze (Bonus) after PVI using second generation cryoballoon...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250268/reconnection-rate-and-long-term-outcome-with-adenosine-provocation-during-cryoballoon-ablation-for-pulmonary-vein-isolation
#8
Rachel M Kaplan, Sanjay Dandamudi, Martha Bohn, Nishant Verma, Todd T Tomson, Rishi Arora, Alexandru B Chicos, Jeffrey J Goldberger, Susan S Kim, Bradley P Knight, Albert C Lin, Rod S Passman
Background: Adenosine can unmask dormant conduction during pulmonary vein isolation (PVI) for atrial fibrillation (AF). Studies of adenosine use in radiofrequency PVI show high reconnection rates and conflicting results for long-term success, however there is limited data with cryoballoon ablation (CBA). Methods: A prospectively maintained database of patients undergoing first CBA at a single institution was analyzed. Adenosine use was at the discretion of the primary operator...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250247/coronary-air-embolism-during-cryoablation-of-atrial-fibrillation-a-catastrophic-complication-and-its-management
#9
Serkan Cay, Ozcan Ozeke, Firat Ozcan, Serkan Topaloglu, Dursun Aras
Various acute complications and their management during ablation of atrial fibrillation have been described. In the current report, coronary air embolism, its acute adverse effects and management of the problem were presented in a patient underwent cryoballoon ablation of atrial fibrillation.
October 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250242/new-migraine-with-visual-disturbance-after-cryoballoon-ablation-of-atrial-fibrillation
#10
Annupreet Nadha, Eric S Williams
We report the case of a 58-year-old woman who developed a headache and visual disturbances after a cryoballoon ablation procedure for atrial fibrillation at our institution. She presented to the emergency department four days post ablation and was admitted the hospital for overnight observation. Serial neurological examinations and neuroimaging were unremarkable for stroke or transient ischemic attack. The patient had some brief transient visual changes which resolved completely after several days, with no further clinical sequelae...
October 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29247032/thromboembolic-risks-of-the-procedural-process-in-second-generation-cryoballoon-ablation-procedures-analysis-from-real-time-transcranial-doppler-monitoring
#11
Shinsuke Miyazaki, Tomonori Watanabe, Takatsugu Kajiyama, Jin Iwasawa, Sadamitsu Ichijo, Hiroaki Nakamura, Hiroshi Taniguchi, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: Atrial fibrillation ablation is associated with substantial risks of silent cerebral events (SCEs) or silent cerebral lesions. We investigated which procedural processes during cryoballoon procedures carried a risk. METHODS AND RESULTS: Forty paroxysmal atrial fibrillation patients underwent pulmonary vein isolation using second-generation cryoballoons with single 28-mm balloon 3-minute freeze techniques. Microembolic signals (MESs) were monitored by transcranial Doppler throughout all procedures...
December 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29247029/time-to-effect-based-dosing-strategy-for-cryoballoon-ablation-in-patients-with-paroxysmal-atrial-fibrillation-results-of-the-plusone-multicenter-randomized-controlled-noninferiority-trial
#12
RANDOMIZED CONTROLLED TRIAL
Ángel Ferrero-de-Loma-Osorio, Amaya García-Fernández, Jesús Castillo-Castillo, Maite Izquierdo-de-Francisco, Alicia Ibáñez-Críado, Jose Moreno-Arribas, Angel Martínez, Vicente Bertomeu-González, Patricia López-Mases, María Ajo-Ferrer, Carlos Núñez, Lourdes Bondanza-Saavedra, Juan Miguel Sánchez-Gómez, Juan Gabriel Martínez-Martínez, Francisco Javier Chorro-Gascó, Ricardo Ruiz-Granell
BACKGROUND: The optimal dosage of cryotherapy during cryoballoon ablation of pulmonary veins is still unclear. This trial tested the noninferiority of a novel, individualized, cryotherapy-dosing strategy for each vein. METHODS AND RESULTS: This prospective, randomized, multicenter, noninferiority study included 140 patients with paroxysmal atrial fibrillation, which was refractory to antiarrhythmic drugs. Patients were randomly assigned to a conventional strategy of 180-second cryoballoon applications per vein with a bonus freeze (control group, n=70) or to a shorter-time application protocol, with 1 application that lasted the time required for electric block time to effect plus 60- and a 120-second freeze bonus (study group, n=70)...
December 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29227008/ice-or-fire-comparison-of-second-generation-cryoballoon-ablation-and-radiofrequency-ablation-in-patients-with-symptomatic-persistent-atrial-fibrillation-and-an-enlarged-left-atrium
#13
Ersan Akkaya, Alexander Berkowitsch, Sergej Zaltsberg, Harald Greiss, Christian W Hamm, Johannes Sperzel, Thomas Neumann, Malte Kuniss
INTRODUCTION: We aimed to compare arrhythmia recurrence rates after second-generation cryoballoon (CB-Adv) ablation and radiofrequency (RF) ablation in patients with symptomatic persistent atrial fibrillation (AF) and left atrial (LA) enlargement. METHODS AND RESULTS: Persistent AF patients with LA enlargement were compared using a propensity-score-matching algorithm, and 111 patients treated with CB-Adv ablation and 111 patients treated with RF ablation were selected...
December 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29225299/predictors-of-a-persistent-status-of-pulmonary-vein-electrical-isolation-by-a-cryoballoon-application-for-drug-refractory-atrial-fibrillation
#14
Naohiko Kawaguchi, Kaoru Okishige, Yasuteru Yamauchi, Manabu Kurabayashi, Kenzo Hirao
BACKGROUND: Pulmonary vein isolation (PVI) using a cryoballoon (CB) is utilized for treating atrial fibrillation. This study aimed to assess the effect of the procedural characteristics of CB-based PVI (CB-PVI) on late PV reconnections.Methods and Results:A total of 389 consecutive patients underwent the CB-PVI as their index procedure; 45 consecutive patients underwent re-do procedures (184±87 days after the index CB-PVI). A total of 146 of 178 PVs (82%) remained isolated. The occlusion grade was evaluated in 171 PVs...
December 8, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29211301/outcome-in-patients-with-left-common-pulmonary-vein-after-cryoablation-with-second-generation-cryoballoon
#15
Thomas Beiert, Pia C Lodde, Lutz P T Linneborn, Jessica Werner, Lisa Prinz, Florian Stöckigt, Markus Linhart, Lars Lickfett, Georg Nickenig, Jan W Schrickel, René P Andrié
BACKGROUND: Pulmonary vein isolation (PVI) has become a widely accepted therapy in patients suffering from symptomatic atrial fibrillation (AF). HYPOTHESIS: AF-free survival differs in patients with left common pulmonary vein (LCPV) after PVI with second-generation cryoballoon. METHODS: We included patients scheduled for first PVI for paroxysmal or persistent AF. Symptomatic and/or documented arrhythmia episodes (>30 seconds) were defined as AF recurrence, excluding a 3-month blanking period...
December 6, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29208256/combined-cryoballoon-and-radiofrequency-ablation-versus-radiofrequency-ablation-alone-for-long-standing-persistent-atrial-fibrillation
#16
COMPARATIVE STUDY
Tümer Erdem Guler, Tolga Aksu, Kivanc Yalin, Sukriye Ebru Golcuk, Ferit Onur Mutluer, Serdar Bozyel
BACKGROUND: To achieve sinus rhythm, ablation of long-standing persistent atrial fibrillation (LSPAF) usually requires substrate modification in addition to pulmonary vein isolation (PVI). In the present article, we aimed to compare clinical and substrate modification effects of 2 distinct PVI strategies during stepwise ablation in patients with LSPAF: (1) Combined approach: cryoballoon (CB) for PVI and radiofrequency (RF) ablation for substrate modification and (2) RF-only approach: RF ablation for both PVI and substrate modification...
December 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29196089/atrial-fibrillation-ablation-with-the-second-generation-cryoballoon-multicenter-propensity-score-matched-comparison-between-freezing-strategies
#17
Erwin Ströker, Kaspars Kupics, Carlo de Asmundis, Giacomo Mugnai, Valentina de Regibus, Jeroen De Cocker, Dirk Stockman, Saverio Iacopino, Juan Sieira-Moret, Pedro Brugada, Bruno Schwagten, Yves De Greef, Gian-Battista Chierchia
BACKGROUND: Second generation cryoballoon (CB-A) ablation is highly effective in achieving pulmonary vein (PV) isolation and freedom from atrial fibrillation (AF). However, the ideal freezing strategy is still under debate. Our objective was to investigate the efficacy and outcome between different freezing strategies used with the CB-A in a multicenter, matched population. METHODS: From a total cohort of 1018 patients having undergone CB-A ablation for drug-refractory AF, 673 patients with follow-up ≥6months were included and stratified according to the applied freezing strategy: bonus freeze (BF) versus single freeze (SF)...
November 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29182748/phrenic-nerve-injury-during-right-inferior-pulmonary-vein-ablation-with-the-second-generation-cryoballoon-clinical-procedural-and-anatomical-characteristics
#18
Juan-Pablo Abugattas, Carlo de Asmundis, Saverio Iacopino, Francesca Salghetti, Ken Takarada, Hugo-Enrique Coutiño, Erwin Ströker, Valentina De Regibus, Yves de Greef, Pedro Brugada, Juan Sieira, Gian-Battista Chierchia
Aims: There is still sparse information regarding phrenic nerve injury (PNI) during ablation of the right inferior pulmonary vein (RIPV) by means of the second-generation cryoballoon advance (CB-A). The aim of this study was to describe the procedural, anatomical, and clinical characteristics of patients who experienced PNI during the RIPV ablation. Methods and results: Consecutive patients who had undergone pulmonary vein isolation (PVI) using CB-A and suffered PNI during RIPV ablation were retrospectively included in our study...
November 22, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29161372/plaaf-score-as-a-novel-predictor-of-long-term-outcome-after-second-generation-cryoballoon-pulmonary-vein-isolation
#19
Ersan Akkaya, Alexander Berkowitsch, Harald Greiss, Christian W Hamm, Johannes Sperzel, Thomas Neumann, Malte Kuniss
Aims: Predictors of atrial arrhythmia recurrence have not been described in a long-term follow-up study of patients undergoing pulmonary vein isolation (PVI) using the cryoballoon technique. We aimed to evaluate the efficacy of a second-generation cryoballoon and identify pre-procedural predictors of 3-year outcome after PVI. Methods and results: For this observational cohort study, we enrolled 440 patients ablated at our institution with a second-generation cryoballoon...
November 16, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29161368/management-of-cardiac-tamponade-in-catheter-ablation-of-atrial-fibrillation-single-centre-15%C3%A2-year-experience-on-5222-procedures
#20
Rikuta Hamaya, Shinsuke Miyazaki, Hiroshi Taniguchi, Shigeki Kusa, Hiroaki Nakamura, Hitoshi Hachiya, Takatsugu Kajiyama, Tomonori Watanabe, Miyako Igarashi, Kenzo Hirao, Yoshito Iesaka
Aims: Cardiac tamponade during atrial fibrillation (AF) ablation is infrequent but potentially fatal. This study aimed to retrospectively investigate the incidence, management, and outcomes of tamponade in large patient series. Methods and results: The study analysed 5222 AF ablation procedures in 3483 patients between 2002 and 2016 under a heparin-bridge anticoagulation protocol. Cardiac tamponade occurred in 51 procedures/patients, and the incidence was 0...
November 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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