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Atrial fibrillation and cryoablation

Melanie A Gunawardene, Boris A Hoffmann, Benjamin Schaeffer, Da-Un Chung, Julia Moser, Ruken Oezge Akbulak, Mario Jularic, Christian Eickholt, Jana Nuehrich, Christian Meyer, Stephan Willems
INTRODUCTION: Comparative data of early recurrence rates of atrial fibrillation (ERAF) following second-generation cryoballoon (CB-G2) and radiofrequency current (RFC) ablation for pulmonary vein isolation (PVI) in paroxysmal AF (PAF) are rare. We randomized PAF patients into either PVI with CB-G2 (group 1) or PVI with a combined RFC-approach applying contact force (CF) with the endpoint of unexcitability (group 2) to investigate ERAF. METHODS: In group 1 (n = 30), CB-G2-PVI was performed...
October 14, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Malte Kuniss, Harald Greiß, Dmitri Pajitnev, Ersan Akkaya, Nikolas Deubner, Andreas Hain, Lars Bodammer, Alexander Berkowitsch, Gian-Battista Chierchia, Christian W Hamm, Thomas Neumann
AIMS: Although the generation of linear lesions by ablation improves success rates in patients with persistent atrial fibrillation (AF), the procedure has been considered unsuitable for cryoablation balloon catheter technologies. We developed a technique for linear ablations, using second-generation cryoballoon technology. METHODS AND RESULTS: This was a single-arm, prospective study in 76 patients with persistent AF treated consecutively at our centre. Cryoablation was performed using a 28 mm second-generation cryoballoon...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Jonathan M Kalman, Prashanthan Sanders
No abstract text is available yet for this article.
September 14, 2016: Nature Reviews. Cardiology
Parikshit S Sharma, Santosh K Padala, J Jenkins Thompson, Sampath Gunda, Jayanthi N Koneru, Kenneth A Ellenbogen
INTRODUCTION: The diaphragmatic compound motor action potentials (CMAPs) have been used to predict and prevent phrenic nerve injury (PNI) during cryoballoon ablation of right pulmonary veins. We sought to assess factors that influence the amplitude of the surface CMAP recordings. METHODS AND RESULTS: We analyzed CMAPs from consecutive patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation. CMAP recordings were obtained using ECG electrodes positioned in the "modified lead I" method while stimulating the right PN, until loss of capture (ascertained by palpation and fluoroscopy of the right hemi-diaphragm)...
August 25, 2016: Journal of Cardiovascular Electrophysiology
Uğur Canpolat, Kudret Aytemir, Tuncay Hazirolan, Necla Özer, Ali Oto
BACKGROUND: Left atrial (LA) fibrosis is known as the hallmark for arrhythmogenic substrate in atrial fibrillation (AF). Quantification of LA fibrosis by using delayed-enhanced magnetic resonance imaging (DE-MRI) in AF patients is a pioneering noninvasive technique. Vitamin D (vitD) negatively regulates the renin-angiotensin system, binds to vitD receptors on cardiac myocytes, and has antioxidant properties that may ameliorate the inflammation and proarrhythmic substrate formation. However, its role in LA fibrosis is unclear...
August 20, 2016: Journal of Cardiology
Giacomo Mugnai, Darragh Moran, Erwin Ströker, Diego Ruggiero, Hugo Enrique Coutino-Moreno, Ken Takarada, Valentina De Regibus, Rajin Choudhury, Saverio Iacopino, Pasquale Filannino, Vincent Umbrain, Stefan Beckers, Pedro Brugada, Carlo de Asmundis, Gian-Battista Chierchia
PURPOSE: Our aim was to analyse the temperature behaviour during second-generation cryoballoon ablation (CB-A) in patients with ongoing atrial fibrillation (AF) compared with those in sinus rhythm (SR). METHODS: Consecutive patients with drug-resistant AF who underwent pulmonary vein (PV) isolation by CB-A from April 2014 to May 2015 were analysed. The exclusion criteria were any contraindication for the procedure including the presence of an intracavitary thrombus, uncontrolled heart failure, contraindications to general anaesthesia and cardioversion to SR during the ablation procedure...
August 15, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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
Shinsuke Miyazaki, Hiroshi Taniguchi, Hitoshi Hachiya, Hiroaki Nakamura, Takamitsu Takagi, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: Electrical reconnections after pulmonary vein isolation (PVI) are common in catheter ablation. This study aimed to evaluate the impact of the ablation method on the durability of cryothermal PVI. METHODS: One hundred thirty-two consecutive paroxysmal atrial fibrillation patients undergoing cryothermal PVI were enrolled. PVI was performed with one 28-mm second-generation balloon using 3-minute freeze techniques, and touch-up lesions were created by focal cryothermal applications...
October 1, 2016: International Journal of Cardiology
İsmail Erden, Emine Çakcak Erden, Ebru Golcuk, Tolga Aksu, Kıvanç Yalin, Tümer Erdem Güler, Kazım Serhan Özcan, Burak Turan
BACKGROUND: The aim of our study was to demonstrate the added value of routine transesophageal echocardiography (TEE) for correctly positioning the transseptal system in the fossa ovalis (FO), thus potentially preventing complications during fluoroscopy-guided transseptal puncture (TP), and for assessing the optimal puncture site within the FO according to the expected procedure type. METHODS: Ninety-one patients undergoing pulmonary vein isolation (PVI) procedures by cryoballoon technique for drug-resistant paroxysmal or persistent atrial fibrillation (AF) were prospectively included...
June 2016: Journal of Arrhythmia
S Tzeis, S Pastromas, A Sikiotis, G Andrikopoulos
Ablation of atrial fibrillation is an established treatment for the management of patients with paroxysmal and persistent atrial fibrillation. The complex pathophysiology of persistent atrial fibrillation has fuelled the concept of adjunctive substrate modification on top of pulmonary vein isolation. However, recent studies have failed to demonstrate additive benefit from complex ablation approaches, thus supporting that standalone pulmonary vein isolation may prove sufficient, at least as the initial ablation strategy in persistent atrial fibrillation...
September 2016: Netherlands Heart Journal
Bor Antolič, Andrej Pernat, Marta Cvijić, David Žižek, Matevž Jan, Matjaž Šinkovec
BACKGROUND: Evidence from animal and human studies suggests that cryoablation might be associated with a lesser inflammatory response and activation of coagulation compared with radiofrequency ablation. The study was aimed at comparing the effect of cryoballoon and radiofrequency catheter ablation of paroxysmal atrial fibrillation on markers of myocardial damage, inflammation, and activation of coagulation. METHODS: Forty-one patients received either cryoballoon (n = 23) or radiofrequency (n = 18) ablation of atrial fibrillation...
July 2016: Wiener Klinische Wochenschrift
Rui Providencia, Pascal Defaye, Pier D Lambiase, Dominique Pavin, Jean-Pierre Cebron, Franck Halimi, Frédéric Anselme, Neil Srinivasan, Jean-Paul Albenque, Serge Boveda
AIM: Cryoballoon ablation (Cryoballoon) has emerged as a new alternative for the treatment of symptomatic drug-refractory atrial fibrillation (AF). Whether the results of Cryoballoon are more reproducible than those of radiofrequency (RF) ablation remains to be proved. METHODS AND RESULTS: A total of 860 consecutive patients undergoing a first ablation procedure for paroxysmal AF (467 treated with RF and 393 treated with Cryoballoon) were selected from a prospective multicentre survey of AF ablation (FrenchAF)...
June 5, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Gabriella Boano, Meriam Åström Aneq, Jennie Kemppi, Farkas Vánky
OBJECTIVE: The indications for and the risk and benefit of concomitant surgical ablation for atrial fibrillation (AF) have not been fully delineated. Our aim was to survey whether the Cox-maze IV procedure is associated with postoperative heart failure (PHF) or other adverse short-term outcomes after mitral valve surgery (MVS). DESIGN: Consecutive patients with AF undergoing MVS with (n = 50) or without (n = 66) concomitant Cox-maze IV cryoablation were analysed regarding perioperative data and one-year mortality...
June 16, 2016: Scandinavian Cardiovascular Journal: SCJ
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
Shinsuke Miyazaki, Hiroshi Taniguchi, Hitoshi Hachiya, Hiroaki Nakamura, Takamitsu Takagi, Jin Iwasawa, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: The post-second-generation cryoballoon (CB) ablation isolation area during the chronic phase has not been described. The aim of this study was to quantitatively evaluate the chronic-phase isolation area after 28-mm second-generation CB ablation and compare it to the estimated conventional radiofrequency circumferential pulmonary vein isolation (CPVI) line. METHODS AND RESULTS: Thirty-two patients with paroxysmal atrial fibrillation underwent pulmonary vein (PV) isolation using second-generation CB...
May 2016: Circulation. Arrhythmia and Electrophysiology
Tolga Aksu, Kıvanç Yalın, Ebru Gölcük, Tümer Erdem Güler
A case of long-standing persistent atrial fibrillation (LPAF) that underwent hybrid treatment combining transvenous cryothermal and radiofrequency (RF) energy is described in the present report. Complex fractionated atrial electrogram (CFAE) maps before and after cryoablation revealed not only pulmonary vein isolation (PVI), but also a large antral ablation of CFAEs. Following cryoablation, a severe reduction in remote left atrial CFAE area was observed.
March 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Xiaobing Li, Limimg Liu, Long Song, Cheng Luo, Benli Yang, Yuhong Liu
OBJECTIVE: To summarize the clinical data of patients who experienced cryoablation in minimally invasive mitral valve surgery and to explore safety and effectiveness of the surgery.
 METHODS: We retrospectively collected the clinical data of patients who experienced cryoablation in minimally invasive mitral valve surgery in Department of Cardiovascular of Second Xiangya Hospital from August 2013 to July 2015. Through a right side (4-6 cm) thoracotomy, femoral cannulation and aortic cross-clamp by Chitwood clamper was performed, left atrium was entered from interatrial groove...
March 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Kadri Murat Gurses, Duygu Kocyigit, Muhammed Ulvi Yalcin, Hande Canpinar, Hikmet Yorgun, Mehmet Levent Sahiner, Ergun Baris Kaya, Mehmet Ali Oto, Necla Ozer, Dicle Guc, Kudret Aytemir
Atrial fibrillation (AF) is the most common sustained arrhythmia. Inflammation has been suggested to play a vital role in the pathogenesis. Previous studies have investigated expression of inflammatory markers in AF. Several studies have focused on the effects of toll-like receptors (TLRs) on heart in terms of capability of modulating inflammation. In this study, we aimed to investigate whether peripheral monocyte TLR expression was associated with the AF presence, and recurrence of AF after cryoablation, as a reflection of inflammatory status...
May 1, 2016: American Journal of Cardiology
Tuan Nguyen, Umjeet Jolly, Kiran Sidhu, Raymond Yee, Peter Leong-Sit
Atrial fibrillation (AF) is an increasing global issue leading to increased hospitalizations, adverse health related events and mortality. This review focuses on the management of atrial fibrillation, in particular in the past decade, comparing two major strategies, rate or rhythm control. We evaluate the evidence for each strategy, pharmacological options and the increasing utilization of invasive techniques, in particular catheter ablation and use of implantable cardiac pacing devices. Pharmacological comparative trials evaluating both strategies have shown rate control being non-inferior to rhythm control for clinical outcomes of mortality and other cardiovascular events (including stroke)...
June 2016: Expert Review of Cardiovascular Therapy
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
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