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Atrial fibrillation and cryoablation

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https://www.readbyqxmd.com/read/28625929/verification-of-a-novel-atrial-fibrillation-cryoablation-dosing-algorithm-guided-by-time-to-pulmonary-vein-isolation-results-from-the-cryo-dosing-study-cryoballoon-ablation-dosing-based-on-the-assessment-of-time-to-effect-and-pulmonary-vein-isolation-guidance
#1
Arash Aryana, David N Kenigsberg, Marcin Kowalski, Charles H Koo, Hae W Lim, Padraig Gearoid O'Neill, Mark R Bowers, Robert B Hokanson, Kenneth A Ellenbogen
BACKGROUND: There are no recommendations on the optimal dosing for cryoablation of atrial fibrillation (Cryo-AF). OBJECTIVE: We developed and prospectively tested a Cryo-AF dosing protocol guided exclusively by time-to-pulmonary vein (PV) isolation (TT-PVI) in patients undergoing a first-time Cryo-AF. METHODS: In this multicenter study, we examined the acute/long-term safety/efficacy of Cryo-AF using the proposed dosing algorithm (Cryo-AFDosing, n=355) against a conventional, non-standardized approach (Cryo-AFConventional, n=400) in a non-randomized fashion...
June 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28496076/-early-results-of-complex-fractionated-atrial-electrogram-mapping-guided-atrial-fibrillation-surgery
#2
Kazuaki Fukahara, Mari Sakai, Shigeki Yokoyama, Toshio Doi, Naoki Yoshimura
OBJECTIVE: Although the Cox-maze operation is the standard surgical procedure for permanent atrial fibrillation(AF), conversion to sinus rhythm is limited by patient characteristics, including the duration of AF, atrial size, and voltage of fibrillation waves. A surgical strategy based on structural alteration of the electrical substrates of AF is required to achieve better outcomes of AF surgery. Complex fractionated atrial electrogram (CFAE) plays an important role in the electrical substrate of AF...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28485513/first-description-of-a-double-wall-balloon-breach-during-cryoballoon-ablation-for-atrial-fibrillation
#3
Keith Suarez, Javier Banchs, Hae W Lim, James N Black
Balloon breach during cryoablation: To date, this is the first published report of a double-wall breach while using the cryoballoon ablation catheter during the treatment of a patient with atrial fibrillation; however, there have been previous balloon breaches in both the second and third-generation cryoballoon ablation catheter usage. In this report, we describe the case of a double-wall balloon breach and the intraoperative care that was necessary to stabilize the patient. Additionally, we review other known cases of double-wall balloon breaches, and we examine the safety systems of the cryoballoon catheter that mitigate some of the potential patient complications...
May 9, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28460771/pressure-guided-cryoablation-of-pulmonary-veins-in-atrial-fibrillation-a-fast-and-effective-strategy
#4
Amol Raizada, Maheedhar Gedela, Kashif Abbas Shaikh, Nachiket Apte, Max DeHaan, Christopher Stanton
BACKGROUND: Cryoballoon ablation of atrial fibrillation (AF) involves successful electrical pulmonary vein isolation (PVI). Pulmonary vein (PV) ostial occlusion with cryoballoon is classically assessed using PV angiography. A pressure-guided technique to assess ostial occlusion has been evaluated in small cohorts with mixed results. We evaluated the efficacy of this pressure-guided PVI technique and its impact on reducing contrast and fluoroscopy time as compared to the traditional approach...
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28449531/ablation-of-atrial-fibrillation-single-shot-techniques-poised-to-dominate-rhythm-control-strategies-the-future-is-here
#5
EDITORIAL
Antonis S Manolis
Over the recent years, the advent of single-shot techniques, such as circular catheter and cryoballoon ablation, has ushered in a new era in the catheter ablation approach and rhythm control strategies of patients with atrial fibrillation (AF). These techniques make it easier to navigate the heart and have the potential to decrease the threshold for, expand the access to, and increase patient and physician acceptance of rhythm-control therapies, that may lead to reduction of the AF disease burden and its socioeconomic impact...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28417287/predictors-of-arrhythmia-recurrence-after-balloon-cryoablation-of-atrial-fibrillation-the-value-of-caap-af-risk-scoring-system
#6
Mohamed Sanhoury, Massimo Moltrasio, Fabrizio Tundo, Stefania Riva, Antonio Dello Russo, Michela Casella, Claudio Tondo, Gaetano Fassini
PURPOSE: In the present study, we aimed to test the value of CAAP-AF score for prediction of atrial fibrillation (AF) recurrence at follow-up in a group of our patients treated by balloon cryoablation. METHODS: A total of 283 symptomatic drug-refractory AF patients [261 (92%) with paroxysmal AF] who underwent pulmonary vein isolation (PVI) with second-generation cryoballoon between April 2012 and October 2016 were included. The CAAP-AF score was calculated for every patient...
April 18, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28357713/relationship-of-the-lungs-to-the-left-atrium-of-particular-relevance-for-ablation-of-atrial-fibrillation
#7
Katie A Walsh, David Keane, Gerard J Fahy
BACKGROUND: Symptoms of possible lung and pleural injury such as chest pain and hemoptysis occur during and after radiofrequency ablation (RFA) and cryoablation (CA) of the left atrium (LA) for treatment of atrial fibrillation (AF). We determined the anatomical relationship of the lungs to the LA with particular reference to areas commonly targeted during AF ablation. METHODS: Distances from the LA endocardium to the lungs were measured from pre-procedure CT angiograms of 100 consecutive patients (71 males, age 60 ± 8 years) who underwent AF ablation...
March 29, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28326843/characteristics-of-the-new-atricure-cryoform%C3%A2-cryoablation-probe-for-the-surgical-treatment-of-cardiac-arrhythmias
#8
Thomas Schroeter, Martin Misfeld
Atrial fibrillation has a significant impact on patient mortality and morbidity. In particular, stroke is a frequent complication associated with atrial fibrillation. In recent years, various treatment options have been developed that are based on the elimination of atypical electrically active atrial areas. Areas covered: This manuscript presents a new cryoablation probe from AtriCure Inc. In addition to describing the characteristics of the probe, we also discuss atrial fibrillation and its surgical therapy options as well as the basics of cryosurgery...
April 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28243805/radiofrequency-catheter-ablation-for-redo-procedures-after-pulmonary-vein-isolation-with-the-cryoballoon-technique-long-term-outcome
#9
Klaus Kettering, Felix Gramley
BACKGROUND: Catheter ablation has become the first line of therapy in patients with symptomatic, recurrent, drug-refractory atrial fibrillation (AF). Cryoablation has been shown to be a safe and effective technique for pulmonary vein (PV) isolation. However, the arrhythmia recurrence rate is high after cryoablation procedures. Radiofrequency catheter ablation has been shown to be an effective strategy for redo procedures in these patients and to provide a favourable outcome during midterm follow-up...
February 27, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28215479/lessons-from-individualized-cryoballoon-sizing-is-there-a-role-for-the-small-balloon
#10
Stefan Hartl, Uwe Dorwarth, Benedikt Bunz, Michael Wankerl, Ullrich Ebersberger, Ellen Hoffmann, Florian Straube
BACKGROUND: Cryoablation for paroxysmal atrial fibrillation (PAF) is well established. The single-big-balloon strategy has been preferred for pulmonary vein isolation (PVI) using the second generation cryoballoon (CBG2). Individual PV-morphologies raise the question if an individualized anatomic approach using the 23-mm or 28-mm CB is reasonable. METHODS: Consecutive patients were prospectively enrolled in the non-randomized single-center study. Patients were treated with the 28-mm CB, if any PV was >21mm, the 23-mm CB, if all PV were ≤21mm, or both sizes, if PVI was difficult...
February 16, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28211197/recurrences-in-the-blanking-period-and-12-month-success-rate-by-continuous-cardiac-monitoring-after-cryoablation-of-paroxysmal-and-non-paroxysmal-atrial-fibrillation
#11
Paolo Pieragnoli, Alessandro Paoletti Perini, Giuseppe Ricciardi, Luca Checchi, Andrea Giomi, Iacopo Muraca, Letizia Mannucci, Luigi Padeletti
INTRODUCTION: Recurrences within the blanking period (early recurrences) are common after atrial fibrillation (AF) ablation by pulmonary vein isolation (PVI), but their clinical significance is still controversial. We aimed at evaluating the significance of within-blanking recurrences at 12-month follow-up after cryoballoon (CB) PVI, and to assess the real procedural success rate by continuous monitoring of cardiac rhythm. METHODS AND RESULTS: Sixty consecutive AF patients (34 paroxysmal, 56...
June 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28187972/late-results-of-the-cox-maze-iv-procedure-in-patients-undergoing-coronary-artery-bypass-grafting
#12
Matthew R Schill, Farah N Musharbash, Vivek Hansalia, Jason W Greenberg, Spencer J Melby, Hersh S Maniar, Laurie A Sinn, Richard B Schuessler, Marc R Moon, Ralph J Damiano
OBJECTIVE: Most patients with atrial fibrillation (AF) undergoing cardiac surgery do not receive concomitant ablation. This study reviewed outcomes of patients with AF undergoing Cox-maze IV (CMIV) procedure with radiofrequency and cryoablation and coronary artery bypass grafting (CABG) at our institution. METHODS: Between the introduction of radiofrequency ablation in 2002 and 2015, 135 patients underwent left- or biatrial CMIV with CABG. Patients undergoing other cardiac procedures, except mitral valve repair, or who had emergent, reoperative, or off-pump procedures were excluded...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28127119/repeat-ablation-and-hospitalization-following-cryoballoon-ablation-of-atrial-fibrillation-at-a-single-tertiary-medical-center
#13
Cara East, Teresa Phan, Giovanni Filardo, Jay Franklin, Alan Donsky, Kevin R Wheelan, Robert C Kowal
Cryoablation for atrial fibrillation (AF) has rapidly become a mainstream treatment for AF. In this report, 163 patients who had undergone a cryoablation procedure at one clinical center were contacted by telephone 33.1 ± 3.3 months after the procedure. All patients had received cryoablation of the pulmonary vein ostia, although concomitant procedures were performed at the same time in over 50% of the patients, including radiofrequency and/or cryoablation of other areas of the left atrium. Freedom from a repeat ablation procedure was 87%, while freedom from recurrent hospitalization for AF was 89%, as compared to previous reports of 65%...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28106017/relationship-between-serum-osteopontin-level-and-atrial-fibrillation-recurrence-in-patients-undergoing-cryoballoon-catheter-ablation
#14
Hacı Murat Güneş, Gamze Babur Güler, Ekrem Güler, Gültekin Günhan Demir, Filiz Kızılırmak Yılmaz, Mehmet Onur Omaygenç, Ayşe İstanbullu Tosun, Taylan Akgün, Bilal Boztosun, Fethi Kılıçarslan
OBJECTIVE: Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with increased morbidity and mortality. Atrial fibrosis augments recurrence rate following AF catheter ablation. Osteopontin is a multifunctional molecule involved in several pathophysiological pathways, including fibrosis. Presently described is investigation of relationship between serum osteopontin level and AF recurrence after AF cryoablation. METHODS: The study was designed to be prospective and observational; 60 patients with paroxysmal (n=47) and persistent (n=13) AF were included...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28089454/the-role-of-adenosine-challenge-in-catheter-ablation-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#15
Alex J A McLellan, Saurabh Kumar, Catherine Smith, Liang-Han Ling, Sandeep Prabhu, Jonathan M Kalman, Peter M Kistler
AIMS: Adenosine may unmask dormant PV conduction and facilitate consolidation of PV isolation. We performed a meta-analysis to determine the impact of adenosine administration on clinical outcomes in patients undergoing PVI. METHODS: References and electronic databases reporting AF ablation and adenosine following PVI were searched through to 22nd November 2015. The impact of adenosine on freedom from AF was assessed in twenty publications after radiofrequency ablation (RFA), and in four publications after cryoablation to achieve PVI...
June 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28065886/cryoablation-vs-radiofrequency-ablation-for-treatment-of-paroxysmal-atrial-fibrillation-a-systematic-review-and-meta-analysis
#16
Yi-He Chen, Zhao-Yang Lu, Yin- Xiang, Jian-Wen Hou, Qian Wang, Hui Lin, Yi-Gang Li
Aims: Cryoablation is a promising alternative technique to RF ablation for treating paroxysmal AF with encouraging results. However, data about the efficacy and safety comparison between cryoablation and RF ablation is still lacking. Methods and results: We systematically search the PubMed, the Cochrane Library, MEDLINE and Google Scholar databases, and finally identify 16 eligible studies including 7195 patients (2863 for cryoablation; 4332 for RF ablation). Freedom from AF/atrial tachycardial replase is slightly higher in cryoablation than RF ablation during a median 12 months of follow-up, with no statistical significant (RR: 1...
May 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28043429/results-of-cryoablation-for-atrial-fibrillation-concomitant-with-video-assisted-minimally-invasive-mitral-valve-surgery
#17
Giovanni Marchetto, Matteo Anselmino, Chiara Rovera, Samuel Mancuso, Davide Ricci, Marina Antolini, Mara Morello, Fiorenzo Gaita, Mauro Rinaldi
Interest in minimally invasive video-assisted mitral valve surgery (MIMVS) is rapidly growing. Data on concomitant atrial fibrillation (AF) ablation to MIMVS are still lacking. The present study investigates the long-term results of AF cryoablation concomitant to MIMVS. From October 2006-September 2014, 68 patients with mitral valve disease (age 65.9 ± 11.1 years, 34 men out of 68 patients, Euroscore log 5.4 ± 4.5) and drug-resistant AF underwent MIMVS via right minithoracotomy and concomitant left-sided AF endocardial cryoablation (Cryoflex Medtronic, Minneapolis, MN)...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28007093/bronchial-effects-of-cryoballoon-ablation-for-atrial-fibrillation
#18
Nishant Verma, Colin T Gillespie, A Christine Argento, Todd Tomson, Sanjay Dandamudi, Paloma Piña, Sukit Ringwala, Albert C Lin, Alexandru B Chicos, Susan Kim, Rishi Arora, Rod S Passman, Bradley P Knight
BACKGROUND: Damage to extracardiac structures, including the esophagus and phrenic nerve, is a known complication of cryoballoon ablation (CBA) during pulmonary vein (PV) isolation for atrial fibrillation (AF). Other adjacent structures, including the pulmonary bronchi and lung parenchyma, may be affected during CBA at the PV ostia. OBJECTIVE: The purpose of this study was to prospectively study the bronchial effects of CBA in humans undergoing CBA for PV isolation...
January 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27909473/cryoablation-for-the-treatment-of-drug-refractory-symptomatic-atrial-fibrillation-a-regional-medical-center-experience
#19
Robert Tonks, Hiba tul kareem Sayed, Ashley Adams, William T Smith
INTRODUCTION: PVI is an effective, guideline-based treatment for drug refractory symptomatic AF. Balloon cryoablation has been shown to be a safe and effective method for PVI. In the STOP-AF trial, data was produced from practitioners performing PVI with significant experience at high volume centers. This study evaluates the effectiveness and safety of treating symptomatic, drug refractory AF with PVI via cryoablation after implementation in a regional medical center. METHOD: This represents a retrospective analysis of outcomes after cryoablation treatment for AF in 71 patients over 354...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27907904/a-new-cryoenergy-for-ventricular-tachycardia-ablation-a-proof-of-concept-study
#20
Benjamin Berte, Frédéric Sacher, Jean-Yves Wielandts, Saagar Mahida, Xavier Pillois, Rukshen Weerasooriya, Olivier Bernus, Pierre Jaïs
INTRODUCTION: Lack of transmural lesion formation during radiofrequency (RF) ablation for ventricular tachycardia (VT) is an important determinant of arrhythmia recurrence. The aim of this proof-of-concept study was to evaluate safety and efficacy of a new and more powerful cryoablation system for ventricular ablation. METHODS AND RESULTS: Five healthy female sheep (59 ± 6 kg) underwent a surgical sternotomy for epicardial and endocardial access [endocardial access via right atrial appendage and left ventricular (LV) apex]...
October 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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