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Cryo ablation

Joshua Xu, Jessica G Y Luc, Kevin Phan
Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in modern clinical practice, with an estimated prevalence of 1.5-2%. The prevalence of AF is expected to double in the next decades, progressing with age and increasingly becoming a global medical challenge. The first-line treatment for AF is often medical treatment with either rate control or anti-arrhythmic agents for rhythm control, in addition to anti-coagulants such as warfarin for stroke prevention in patient at risk. Catheter ablation has emerged as an alternative for AF treatment, which involves myocardial tissue lesions to disrupt the underlying triggers and substrates for AF...
September 2016: Journal of Thoracic Disease
Renske J E van den Bijgaart, Dylan C Eikelenboom, Martijn Hoogenboom, Jurgen J Fütterer, Martijn H den Brok, Gosse J Adema
Tumor ablation technologies, such as radiofrequency-, cryo- or high-intensity focused ultrasound (HIFU) ablation will destroy tumor tissue in a minimally invasive manner. Ablation generates large volumes of tumor debris in situ, releasing multiple bio-molecules like tumor antigens and damage-associated molecular patterns. To initiate an adaptive antitumor immune response, antigen-presenting cells need to take up tumor antigens and, following activation, present them to immune effector cells. The impact of the type of tumor ablation on the precise nature, availability and suitability of the tumor debris for immune response induction, however, is poorly understood...
September 1, 2016: Cancer Immunology, Immunotherapy: CII
Mirjam C L Peek, Muneer Ahmed, Alessandro Napoli, Sasha Usiskin, Rose Baker, Michael Douek
PURPOSE: Breast-conserving surgery is effective for breast cancer treatment but is associated with morbidity in particular high re-excision rates. We performed a systematic review and meta-analysis to assess the current evidence for clinical outcomes with minimally invasive ablative techniques in the non-surgical treatment of breast cancer. METHODS: A systematic search of the literature was performed using PubMed and Medline library databases to identify all studies published between 1994 and May 2016...
October 2, 2016: International Journal of Hyperthermia
Daniel Pergament Persson, Anle Chen, Mark G M Aarts, David E Salt, Jan K Schjoerring, Søren Husted
Better understanding of root function is central for the development of plants with more efficient nutrient uptake and translocation. We here present a method for multielement bioimaging at the cellular level in roots of the genetic model system Arabidopsis (Arabidopsis thaliana). Using conventional protocols for microscopy, we observed that diffusible ions such as potassium and sodium were lost during sample dehydration. Thus, we developed a protocol that preserves ions in their native, cellular environment...
October 2016: Plant Physiology
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 exists on cryoablation of atrial fibrillation (Cryo-AF) using the newly-available third-generation (AFA-ST) cryoballoon. OBJECTIVE: In this multicenter study, we evaluated the safety and efficacy of Cryo-AF using the AFA-ST versus the second-generation (AFA) cryoballoon. METHODS: We examined the procedural safety and efficacy and acute and mid-term results from 355 consecutive patients (72% with paroxysmal AF) who underwent a first-time Cryo-AF using AFA-ST (n=102) or AFA (n=253)...
August 5, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Emiliano Schena, Daniele Tosi, Paola Saccomandi, Elfed Lewis, Taesung Kim
During recent decades, minimally invasive thermal treatments (i.e., Radiofrequency ablation, Laser ablation, Microwave ablation, High Intensity Focused Ultrasound ablation, and Cryo-ablation) have gained widespread recognition in the field of tumor removal. These techniques induce a localized temperature increase or decrease to remove the tumor while the surrounding healthy tissue remains intact. An accurate measurement of tissue temperature may be particularly beneficial to improve treatment outcomes, because it can be used as a clear end-point to achieve complete tumor ablation and minimize recurrence...
2016: Sensors
Jaspreet S Arora, Hakm Y Murad, Stephen Ashe, Gray Halliburton, Heng Yu, Jibao He, Vijay T John, Damir B Khismatullin
High-intensity focused ultrasound (HIFU) can locally ablate biological tissues such as tumors, i.e., induce their rapid heating and coagulative necrosis without causing damage to surrounding healthy structures. It is widely used in clinical practice for minimally invasive treatment of prostate cancer. Nonablative, low-power HIFU was established as a promising tool for triggering the release of chemotherapeutic drugs from temperature-sensitive liposomes (TSLs). In this study, we combine ablative HIFU and thermally triggered chemotherapy to address the lack of safe and effective treatment options for elderly patients with high-risk localized prostate cancer...
September 6, 2016: Molecular Pharmaceutics
Ken Okumura, Kazuo Matsumoto, Yoshinori Kobayashi, Akihiko Nogami, Robert B Hokanson, Fred Kueffer
BACKGROUND: Outcomes of cryoballoon ablation for paroxysmal atrial fibrillation (PAF) have been reported in the Western countries but not in Japan. The CRYO-Japan PMS study was a single-arm, observational, multicenter, prospective study of the 2nd-generation cryoballoon Arctic Front Advance(TM). We evaluated device- and procedure-related complications and clinical outcomes at 6 months. METHODS AND RESULTS: The 616 patients (male, 72%; mean age, 63±11 years) were enrolled from 33 Japanese hospitals...
July 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation 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
Tina Büchner, Daniela Drescher, Virginia Merk, Heike Traub, Peter Guttmann, Stephan Werner, Norbert Jakubowski, Gerd Schneider, Janina Kneipp
Multifunctional composite nanoprobes consisting of iron oxide nanoparticles linked to silver and gold nanoparticles, Ag-Magnetite and Au-Magnetite, respectively, were introduced by endocytic uptake into cultured fibroblast cells. The cells containing the non-toxic nanoprobes were shown to be displaceable in an external magnetic field and can be manipulated in microfluidic channels. The distribution of the composite nanostructures that are contained in the endosomal system is discussed on the basis of surface-enhanced Raman scattering (SERS) mapping, quantitative laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) micromapping, and cryo soft X-ray tomography (cryo soft-XRT)...
August 15, 2016: Analyst
Serge Boveda, Rui Providência, Pascal Defaye, Dominique Pavin, Jean-Pierre Cebron, Frederic Anselme, Franck Halimi, Ziad Khoueiry, Nicolas Combes, Stephane Combes, Sophie Jacob, Jean-Paul Albenque, Pedro Sousa
PURPOSE: Recent data show no benefit of additional ablation beyond pulmonary vein isolation (PVI) in persistent atrial fibrillation (AF). Evidence suggests that radiofrequency energy (RF) and cryoballoon (CRYO) have comparable efficacy for PVI. We aimed to assess the outcomes after a single catheter ablation procedure, comparing PVI using CRYO vs. RF ablation for PVI plus additional ablation in a cohort of patients with persistent AF. METHODS: In this prospective multicenter propensity score-matched comparison, 59 consecutive patients undergoing CRYO ablation of persistent AF were matched to 59 patients treated with RF from November 2010 to June 2012...
May 18, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Tina D Hunter, Swetha R Palli, John A Rizzo
OBJECTIVE: The objective of this study was to compare the cost of radiofrequency (RF) ablation vs cryoablation (Cryo) for atrial fibrillation (AF). METHODS: This retrospective cohort study used 2013-2014 records from the Premier Healthcare Database for adults with AF catheter ablation. Exclusions included non-AF ablation, surgical ablation, valve replacement or repair, or cardiac implant. Hospitals were required to perform ≥20 procedures using each technology, with the technology identifiable in at least 90% of cases...
October 2016: Journal of Medical Economics
Yousef H Darrat, Anuj Agarwal, Gustavo X Morales, Joseph Thompson, Ahmed Abdel-Latif, Kelly Waespe, Luigi DI Biase, Andrea Natale, Abhijit Patwardan, Claude-Samy Elayi
INTORDUCTION: Medical societies and cardiac implantable electronic device (CIED) manufacturers recommend avoiding close or direct contact between the body of transvenous leads and ablation catheters used to treat cardiac arrhythmias. These recommendations are made despite the lack of clinical studies. However, the target myocardium for successful ablation can be contiguous to CIED leads. METHODS AND RESULTS: We examine in vitro the effects of direct application of radiofrequency (RF) and cryo-ablation energy on the integrity and functionality of CIED leads (excluding the pacing electrodes and defibrillation coils)...
August 2016: Journal of Cardiovascular Electrophysiology
Arash Aryana, Mark R Bowers, Sa Man Hayatdavoudi, Yanhong Zhang, Alaa Afify, André D'Avila, Padraig Gearoid O'Neill
INTRODUCTION: There is a paucity of data on the mechanisms of cough and hemoptysis that sometimes ensue from cryoballoon ablation of pulmonary veins (Cryo-PV). This study specifically examined the impact of ultra-cold (≤-60 °C, 3 minutes), prolonged (>-55 °C, 6 minutes), and conventional (>-55 °C, 3 minutes) Cryo-PV on lung/bronchial injury. METHODS AND RESULTS: Four healthy adult swine underwent Cryo-PV. Each animal received Cryo-PV to the inferior common trunk and the right superior PV...
July 2016: Journal of Cardiovascular Electrophysiology
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
Nirmish Singla, Jeffrey Gahan
PURPOSE OF REVIEW: The application of ablative modalities for small renal masses continues to increase. In addition, multiple technologies continue to be studied for the treatment of these renal masses. This review focuses on new and emerging technologies so that the clinician can become more familiar with these modalities as they become available in clinical practice. RECENT FINDINGS: Radiofrequency ablation (RFA) and cryoablation (cryo) continue to be the most often used ablative modalities for the treatment of small renal masses...
May 2016: Current Opinion in Urology
Philipp Attanasio, Martin Huemer, Abdul Shokor Parwani, Leif-Hendrik Boldt, Andreas Mügge, Wilhelm Haverkamp, Alexander Wutzler
BACKGROUND: Left atrial ablation can be accompanied by discomfort or pain. The purpose of this study was to systematically compare pain reactions during ablation of atrial fibrillation under deep sedation with cryothermal and radiofrequency energy. METHODS AND RESULTS: Circumferential ablation was performed in patients with atrial fibrillation using either radiofrequency (RF) or cryoenergy. Deep sedation was achieved with a combination of propofol and midazolam...
May 2016: Pacing and Clinical Electrophysiology: PACE
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
Deepak Padmanabhan, Samuel J Asirvatham
No abstract text is available yet for this article.
April 2016: Pacing and Clinical Electrophysiology: PACE
Ngai-yin Chan
Catheter cryoablation (CRYO) is an alternative approach to radiofrequency (RF) ablation in the treatment of cardiac arrhythmias. The favourable lesion characteristics of CRYO and its unique properties of cryomapping and cryoadhesion make this newer approach especially suitable for the treatment of peri-nodal substrates, such as atrioventricular nodal re-entrant tachycardia and septal accessory pathway, and pulmonary veno-atrial substrate in atrial fibrillation. This review aims to present and discuss the data on the use of catheter CRYO for these substrates with special emphasis on its efficacy and safety compared with RF ablation...
October 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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