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Afib cryo ablation

T S Tischer, R Schneider, J Lauschke, C Nesselmann, G Steinhoff, Dietmar Bänsch
AIM: Several tools have been invented for surgical atrial fibrillation (AF) ablation. In this study, we investigated the real world efficacy of intraoperative AF ablation (AFA) with radiofrequency-energy or cryo-ablation and performed an electro-anatomical remap in some patients with recurrences. METHODS: Seventy-three consecutive patients (53 male, median age of 69 ± 7 years) with history of AF underwent cardiac surgery for valve repair (74 % mitral defects, 60 % aortic defects) and/or coronary artery bypass graft procedures (56 %)...
September 2015: Herzschrittmachertherapie & Elektrophysiologie
Irfan M Khurram, John N Catanzaro, Stefan Zimmerman, Vadim Zipunnikov, Ronald D Berger, Alan Cheng, Sunil Sinha, Jane Dewire, Joseph Marine, David Spragg, Hiroshi Ashikaga, Henry Halperin, Hugh Calkins, Saman Nazarian
BACKGROUND:  Catheter ablation utilizing radiofrequency (RF), Cryothermal (Cryo), or Laser energy is effective for treatment of atrial fibrillation (AF). Late gadolinium enhancement magnetic resonance imaging (LGE-MRI) has been used to estimate the burden of left atrial (LA) fibrosis, but no data exist regarding structural changes following each modality. We sought to compare the baseline to postprocedure change in LA scar burden following RF, Cryo, or Laser ablation for treatment of AF...
November 2015: Pacing and Clinical Electrophysiology: PACE
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
Luther Swift, Daniel A B Gil, Rafael Jaimes, Matthew Kay, Marco Mercader, Narine Sarvazyan
BACKGROUND: Percutaneous cryoballoon ablation is a commonly used procedure to treat atrial fibrillation. One of the major limitations of the procedure is the inability to directly visualize tissue damage and functional gaps between the lesions. We seek to develop an approach that will enable real-time visualization of tissue necrosis during cryo- or radiofrequency ablation procedures. METHODS AND RESULTS: Cryoablation of either blood-perfused or saline-perfused hearts was associated with a marked decrease in nicotinamide adenine dinucleotide (NADH) fluorescence, leading to a 60% to 70% loss of signal intensity at the lesion site...
October 2014: Circulation. Arrhythmia and Electrophysiology
Ryan P Goff, Stephanie M Bersie, Paul A Iaizzo
BACKGROUND: Phrenic nerve injury, both left and right, is considered a significant complication of cryoballoon ablation for treatment of drug-refractory atrial fibrillation, and functional recovery of the phrenic nerve can take anywhere from hours to months. OBJECTIVE: The purpose of this study was to focus on short periods of cooling to determine the minimal amount of cooling that may terminate nerve function related to cryo ablation. METHODS: Left and/or right phrenic nerves were dissected from the pericardium and connective tissue of swine (n = 35 preparations)...
October 2014: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Kazuhiko Higuchi
The superior transseptal approach provides excellent exposure for mitral valve reconstruction. For atrial fibrillation, cryoablation is less invasive, simpler, and safer than the Cox maze operation. Combining the superior transseptal approach and cryoablation for mitral valve procedures yields a high recovery rate from atrial fibrillation, similar to that of radiofrequency ablation. Cryoablation-related complications such as thromboembolic events or requirement for a permanent pacemaker were not observed in our consecutive series...
January 2015: Asian Cardiovascular & Thoracic Annals
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
Martin Schmidt, Uwe Dorwarth, Dietrich Andresen, Johannes Brachmann, Karl-Heinz Kuck, Malte Kuniss, Thorsten Lewalter, Stefan Spitzer, Stephan Willems, Jochen Senges, Claus Jünger, Ellen Hoffmann
BACKGROUND: Catheter ablation is used extensively with curative intention in atrial fibrillation. Radiofrequency ablation has long been a standard of care, while cryoballoon technology has emerged as a feasible approach with promising results. Prospective multicenter registry data referring to both ablation technologies in AF ablation therapy are lacking. METHODS: Between January 2007 and August 2011, a total of 3,775 consecutive patients with symptomatic paroxysmal AF who underwent PV ablation in their respective centers were enrolled...
January 2014: Journal of Cardiovascular Electrophysiology
Chee-Hoon Lee, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
BACKGROUND: Left atrial appendage (LAA) resection during the Maze procedure may decrease thromboembolic risks, but its preservation may improve left atrial contractile function. This study compared the clinical effects of LAA resection and preservation after the Maze procedure. METHODS: A retrospective review was made of 379 patients (mean age 53.3 ± 12.6 years, 244 females) who underwent the cryo-Maze procedure in conjunction with mitral surgery from 1999 to 2011...
January 2014: Annals of Thoracic Surgery
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
David Viladés Medel, Julio Marti-Almor, Jose Montiel Serrano, Alessandro Sionis, Rubén Leta Petracca
No abstract text is available yet for this article.
January 2014: European Heart Journal Cardiovascular Imaging
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
Helena Malmborg, Christina Christersson, Stefan Lönnerholm, Carina Blomström-Lundqvist
AIMS: Thrombo-embolic events are one of the most feared complications related to atrial fibrillation (AF) ablation. Since radiofrequency (RF) energy is thought to be associated with a higher risk of thrombus formation than cryoenergy, the purpose of this study was to assess if the degree of activation of coagulation and inflammatory markers differed between ablation procedures performed with a cryoballoon catheter vs. a RF energy-based pulmonary vein ablation catheter (PVAC), respectively...
June 2013: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Domenico Catanzariti, Massimiliano Maines, Carlo Angheben, Maurizio Centonze, Claudio Cemin, Giuseppe Vergara
BACKGROUND: Cryoballoon ablation (CBA) has been proven to be very effective for pulmonary vein (PV) isolation (PVI) if complete occlusion is achieved and conventionally assessed by angiographic injection of contrast within PV lumen. The aim of our study was to assess the usefulness of saline contrast intracardiac echocardiography in guiding CBA with respect to PV angiography. METHODS: Thirty consecutive patients with paroxysmal atrial fibrillation were randomly assigned fluoroscopy plus color-flow Doppler (n = 15; group 1: an iodinated medium as both angiographic and echographic contrast) or contrast intracardiac echocardiography plus color-flow Doppler (n = 15; group 2: saline contrast) for guidance of CBA...
November 2012: Indian Pacing and Electrophysiology Journal
Evgeny Pokushalov, Alexander Romanov, Sergey Artyomenko, Vera Baranova, Denis Losik, Sevda Bairamova, Alexander Karaskov, Suneet Mittal, Jonathan S Steinberg
AIM: Catheter ablation of paroxysmal atrial fibrillation (PAF) is associated with an important risk of early and late recurrence, necessitating repeat ablation procedures. The aim of this prospective randomized patient-blind study was to compare the efficacy and safety of cryoballoon (Cryo) versus radiofrequency (RF) ablation of PAF after failed initial RF ablation procedure. METHODS: Patients with a history of symptomatic PAF after a previous failed first RF ablation procedure were eligible for this study...
March 2013: Journal of Cardiovascular Electrophysiology
Sarah Traullé, Shinsuke Miyazaki, Vincent Mouquet, Maciej Kubala, Jean-Sylvain Hermida
BACKGROUND: Although pulmonary vein (PV) stenosis is a serious complication of radiofrequency PV isolation, the anatomical impact of a combination of two energy sources on PV diameter has not been evaluated. The aim of this study was to evaluate the impact of supplementary point-by-point radiofrequency applications (following PV cryoablation) on the PV orifice diameter. METHODS: Forty-nine patients having undergone PV isolation for drug-refractory atrial fibrillation were included...
December 2012: Pacing and Clinical Electrophysiology: PACE
Taiichi Takasaki, Taijiro Sueda, Katsuhiko Imai, Kazumasa Orihashi, Shinya Takahashi, Tatsuya Kurosaki, Satoru Morita, Naomichi Uchida
PURPOSE: We performed box pulmonary vein isolation and the modified Maze procedure using cryoablation (cryo-maze) to eliminate chronic atrial fibrillation (AF) associated with mitral valve disease from 1999 to 2004. This article compares the elimination rate of chronic AF and the postoperative occurrence of new atrial tachycardia after both procedures over a follow-up period of >5 years. METHODS: A total of 75 patients were enrolled in the study. Among them, 40 patients underwent box pulmonary vein isolation for chronic AF concomitant with solitary mitral valve surgery...
February 2012: General Thoracic and Cardiovascular Surgery
Maciej Wójcik, Sebastien Janin, Thomas Neumann, Malte Kuniss, Alexander Berkowitsch, Damir Erkapic, Sergey Zaltsberg, Katherina Madlener, Andrzej Wysokiński, Christian W Hamm, Heinz F Pitschner
BACKGROUND: Many studies have used creatinine kinase (CK), myocardial bound for CK (CK-MB), and cardiac troponin I (cTnI) and T (cTnT) to evaluate myocardial cells injury after ablation. We applied measurements of the blood concentration of cardio-specific biomarkers as surrogates for the injured cell mass. AIM: To clarify which of the standard biomarkers are useful in the evaluation and quantification of lesions produced by cryoballoon ablation (CBA) during pulmonary vein isolation...
2011: Kardiologia Polska
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