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Atrial fibrillation and cryoablation

Shiwei Huang, Binglin Pan, He Zou, Wei Lin
BACKGROUND: Atrial fibrillation (AF) usually originates from pulmonary veins (PVs) but can also be caused by pulmonary veins outside, such as the coronary sinus (CS), the superior vena cava (SVC), and the ligament of Marshall. CASE PRESENTATION: A 69-year-old male with a history of palpitations for 10 years was referred to our institute because of its recurrence for half a day. A dynamic electrocardiogram revealed sinus rhythm (SR) and paroxysmal AF. Echocardiography demonstrated normal cardiac structure, and physical examination results were unremarkable...
March 13, 2018: BMC Cardiovascular Disorders
Duygu Kocyigit, Muhammed Ulvi Yalcin, Kadri Murat Gurses, Selin Ardali, Gamze Turk, Ugur Canpolat, Banu Evranos, Hikmet Yorgun, Tuncay Hazirolan, Kudret Aytemir
AIMS: Several studies have investigated the influence of pulmonary vein(PV) anatomy on outcomes of atrial fibrillation (AF) ablation. We aimed to evaluate the relationship between PV orientation and AF-free survival following cryoablation. METHODS: 160 patients scheduled for cryoablation between September 2012-March 2014 were included. Patients underwent a pre-procedural cardiac CT scan with retrospective ECG gating. PV orientation was assessed according to the position of the PV orifice relative to the sagittal plane with reference to coronal and horizontal planes...
February 19, 2018: Journal of Cardiovascular Computed Tomography
Ugur Canpolat, Duygu Kocyigit, Kudret Aytemir
Catheter ablation either by using radiofrequency or cryo energy in symptomatic patients with atrial fibrillation (AF) has shown to be effective as compared to anti-arrhythmic drugs. However, all the techniques used during AF ablation are not free of complication. There are several well-known peri-procedural complications in which operators should be informed of the possible risks, cautious during the procedure and able to manage them when occurred. Herein, we aimed to review possible complications of AF cryoablation...
December 2017: Journal of Atrial Fibrillation
Mario Matta, Matteo Anselmino, Federico Ferraris, Marco Scaglione, Fiorenzo Gaita
BACKGROUND: Radiofrequency and cryoballoon pulmonary vein isolation are common approaches for paroxysmal atrial fibrillation treatment, showing similar results in recent multicenter studies, including heterogeneous tools and protocols. The aim of this study is to compare prospectively in a single, high-volume center the outcome of paroxysmal atrial fibrillation ablation performed specifically by second-generation cryoballoon or contact force radiofrequency ablation. METHODS: Consecutive patients scheduled for paroxysmal atrial fibrillation transcatheter ablation have been included and prospectively followed up...
February 9, 2018: Journal of Cardiovascular Medicine
Faraz Khan Luni, Abdur Rahman Khan, Hemindermeet Singh, Haris Riaz, Sonia Ali Malik, Owais Khawaja, Talha Farid, Jennifer Cummings, Mohammed Taleb
BACKGROUND: Ablation is used for treatment of atrial fibrillation (AF) but recurrence is common. Dormant conduction is hypothesized to be responsible for these recurrences, and the role of adenosine in identification and ablation of these pathways is controversial with conflicting results on AF recurrence. MATERIALS AND METHODS: We conducted a meta-analysis for studies evaluating AF ablation and adenosine use. Included in the meta-analysis were human studies that compared ablation using adenosine or adenosine triphosphate (ATP) and reported freedom from AF in patients beyond a minimum follow-up of 6 months...
January 2018: American Journal of the Medical Sciences
Antonio Fasano, Luca Anfuso, Giuseppe Arena, Claudio Pandozi
Background: Cryoablation procedures for pulmonary veins isolation have proved to be a successful treatment of atrial fibrillation, but exposure of surrounding organs to excessively low temperatures is potentially dangerous. Hence the importance of monitoring esophageal temperature and at the same time predicting the thermal field induced by the procedure, so to provide clinicians with a valuable tool to take critical decisions. Methods and Results: We formulate a mathematical model for computing the temperature in the relevant region and we use numerical simulations to interpret recorded clinical data...
April 2017: Journal of Atrial Fibrillation
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
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
Shohreh Honarbakhsh, Ben O'Brien, Richard J Schilling
Background: Trans-septal puncture (TSP) is routinely performed during treatment of atrial fibrillation (AF) and other electrophysiology procedures. The purpose of this retrospective observational study was the analysis of a novel needle free technique employed to gain access to the left atrium (LA). Methods: The SafeSept Needle Free guidewire was delivered, using no needle, to the interatrial septum via a standard cryoablation sheath and dilator under transoesophageal guidance...
August 2017: Journal of Atrial Fibrillation
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
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...
January 2018: Pacing and Clinical Electrophysiology: PACE
Onur Kaypakli, Hasan Koca, Durmuş Yıldıray Şahin, Sefa Okar, Fadime Karataş, Mevlüt Koç
AIM: We aimed to investigate the relationship between the recurrence of AF and P wave duration index (PWDI) in patients with nonvalvular PAF. METHODS: We included 114 patients who underwent cryoballoon catheter ablation with the diagnosis of paroxysmal atrial fibrillation (PAF) (55 male, 59 female; mean age 55.5±10,9years). PWDI was calculated by dividing the Pwd by the PR interval in DII lead of 12‑lead ECG. Patients had regular follow-up visits with 12-lead ECG, medical history and clinical evaluation...
October 9, 2017: Journal of Electrocardiology
Jorge Romero, Andrea Natale, Luigi Di Biase
The role of pulmonary vein isolation in patients with non-paroxysmal atrial fibrillation (AF) is only modest. Several studies have demonstrated the role of the left atrial appendage (LAA) in initiating and maintaining of this arrhythmia. We review in this article the incremental benefit in free-arrhythmia recurrence of LAA electrical isolation in patients undergoing procedures for persistent AF or long standing persistent AF either using radiofrequency ablation, cryoablation or Lariat device implantation. Likewise, acute complications, anticoagulation and the risk of ischemic stroke after LAA electrical isolation (LAAEI) are analyzed...
November 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Serge Boveda
Pulmonary vein isolation is the cornerstone of atrial fibrillation ablation and is effective for preventing arrhythmias recurrences, especially in patients with paroxysmal atrial fibrillation. During the last years, cryoballoon ablation has emerged as an unquestionable alternative approach to radiofrequency ablation. Many non-randomized and randomized trials have proven undoubtedly that cryoballoon ablation displays similar efficacy and overall safety profile, when compared to radiofrequency ablation for the treatment of patients with drug-refractory paroxysmal atrial fibrillation...
November 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Claudio Tondo, Saverio Iacopino, Paolo Pieragnoli, Giulio Molon, Roberto Verlato, Antonio Curnis, Maurizio Landolina, Giuseppe Allocca, Giuseppe Arena, Gaetano Fassini, Luigi Sciarra, Mario Luzi, Massimiliano Manfrin, Luigi Padeletti
BACKGROUND: Pulmonary vein isolation (PVI) is a cornerstone ablation strategy in the management of patients with atrial fibrillation (AF). Consensus guidelines and statements recommend PVI during the index catheter ablation procedure in patients with paroxysmal and persistent AF. OBJECTIVE: The objective of this analysis was to evaluate patients with persistent and long-standing persistent AF who were treated with the cryoballoon ablation catheter by PVI technique...
March 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Dawid Miśkowiec, Jarosław D Kasprzak, Paulina Wejner-Mik, Ewa Szymczyk, Haval D Qawoq, Paweł Życiński, Tomasz Wcisło, Piotr Pagórek, Karolina Kupczyńska, Piotr Lipiec
BACKGROUND: Cryoballoon ablation for atrial fibrillation (cryoAF) is relatively simple, cost-effective and easy procedure. However, general anesthesia during this procedure may have negative impact on patients mortality and morbidity, as well as procedure costs. AIM: We sought to assess the feasibility and safety of conscious sedation during cryoAF. METHODS: Patients (pts) with paroxysmal or persistent, drug-refractory AF who underwent a first procedure of cryoAF were included in our single-center, retrospective study...
October 25, 2017: Minerva Cardioangiologica
Wallyson Pereira Fonseca, Cristiano F Pisani, Sissy Lara, Mauricio Scanavacca
No abstract text is available yet for this article.
December 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Adam Sokal, Sylwia Wójcik, Patrycja Pruszkowska, Oskar Kowalski, Radoslaw Lenarczyk, Agnieszka Liberska, Michał Mazurek, Slawomir Pluta, Zbigniew Kalarus
BACKGROUND: Complex mechanisms of responsible for originating and maintaining of atrial fibrillation (AF) are involved in pathophysiology of this arrhythmia. Inflammation substantially contribute to arrhythmic remodelling of atrial tissue.The aim of the present study is to assess an applicability of ferritin and high sensitive C-reactive protein (hs-CRP) as biomarkers of atrial fibrillation and their usefulness in evaluation of efficacy of cryoablation. MATERIALS AND METHODS: The study population consisted of 40 patients who underwent first AF cryoablation procedure...
October 13, 2017: Postȩpy Higieny i Medycyny Doświadczalnej
Justin Ghosh, Mark A McGuire
Aims: Balloon cryoablation is an accepted method of achieving pulmonary vein isolation for the treatment of atrial fibrillation. The relationship between blood flow in the atrium and cryo energy delivery to the tissue remains poorly understood. Methods and results: Controlled cryoablations were performed in vitro using a pulmonary vein phantom constructed from bovine muscle, providing a 20 mm vein ostium. A temperature sensor was mounted within the 'vein wall' at a 1 mm tissue depth...
October 4, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Louise Bagge, Johan Probst, Steen M Jensen, Per Blomström, Stefan Thelin, Anders Holmgren, Carina Blomström-Lundqvist
Aims: Concomitant surgical ablation of atrial fibrillation (AF) in patients undergoing mitral valve surgery (MVS) has almost become routine despite lack of convincing information about improved quality-of-life (QOL) and clinical benefit. Quality-of-life was therefore assessed after MVS with or without epicardial left atrial cryoablation. Methods and results: Sixty-five patients with permanent AF randomized to MVS with or without left atrial cryoablation, in the double-blinded multicentre SWEDMAF trial, replied to the Short Form 36 QOL survey at 6 and 12 months follow-up...
August 19, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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