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Atrial fibrillation and cryoablation

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https://www.readbyqxmd.com/read/28915140/life-threatening-massive-hemoptysis-after-cryoablation-for-atrial-fibrillation
#1
Vivek Jayaschandran, Amy N Mertens, Vishal K Patel, Bhavinkumar Dalal
A 59-year-old man developed massive hemoptysis, 1 month after undergoing cryoablation procedure for atrial fibrillation. He underwent emergent bronchoscopy that revealed massive, active bleeding with clots requiring repeated suctioning, epinephrine, and cold saline injection. The source of bleeding was identified in a follow-up bronchoscopy performed few days later-a 2×3 cm area of ulceration of the left main stem bronchus which was missed in the initial bronchoscopy owing to blood obscuring the field of vision...
September 14, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28881533/-efficacy-and-safety-of-rivaroxaban-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-cryoablation
#2
C Y Di, Z Wan, W H Lin
Objective: To observe the efficacy and safety of the novel oral anticoagulant Rivaroxaban for anticoagulation therapy in patients with nonvalvular atrial fibrillation (AF) during cryoablation. Methods: A total of 137 AF patients from October 2013 to December 2016 underwent cryoablation were divided into two groups according to the application of anticoagulant drugs: Rivaroxaban group (65 cases) and Heparin group (72 cases). Rivaroxaban group: oral administration of Rivaroxaban 20 mg, once a day, was started 3 days before the cryoablation, no anticoagulant was additionally added during cryoablation, the activated clotting time (ACT) was measured, and oral administration of Rivaroxaban was continued for 3 months after cryoablation...
September 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28840029/profuse-and-acute-hemorrhagic-gastroesophageal-injury-after-cryotherapy-in-a-cardiac-surgery-patient
#3
Hyae-Jin Kim, Hyeon-Jeong Lee, Dowon Lee, Haekyu Kim, A-Rheum Cho, Soeun Jeon, Suyeon Hong
Upper gastrointestinal injury associated with cryoablation and under placement of transesophageal echocardiography (TEE) during cardiac surgery is a rare complication but potentially fatal. During the cryoablation for the treatment of atrial fibrillation, delivered cryoenergy can adversely affect the esophagus, resulting in gastroesophageal ulceration. The TEE probe itself also can induce adverse effects like esophageal ulceration or perforation. In this case report, we describe a case of emergent gastroesophageal injury with massive bleeding that occurred after manipulation of a TEE probe during cryoablation therapy in a cardiac surgery patient...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28838486/evaluation-of-a-novel-cryoprobe-for-atrial-ablation-in-a-chronic-ovine-model
#4
Matthew R Schill, Spencer J Melby, Molly Speltz, May Breitbach, Richard B Schuessler, Ralph J Damiano
PURPOSE: Cryoablation is used in the treatment of atrial fibrillation and other cardiac arrhythmias. This study evaluated a novel 10-cm flexible nitrous oxide cryoprobe in an ovine model of atrial ablation. DESCRIPTION: Six sheep were anesthetized, underwent a left thoracotomy, and were placed on cardiopulmonary bypass. A left atriotomy was performed, and the cryoprobe was applied endocardially for 120 seconds at less than -40°C to 4 sites on the left atrium. The atrium was closed and the animals were allowed to recover...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28818088/assessment-of-the-effect-of-left-atrial-cryoablation-enhanced-by-ganglionated-plexi-ablation-in-the-treatment-of-atrial-fibrillation-in-patients-undergoing-open-heart-surgery
#5
Jiří Bárta, Radim Brát
BACKGROUND: The aim of our study was to investigate, whether enhancement of left atrial cryoablation by ablation of the autonomic nervous system of left atrium leads to influencing the outcomes of surgical treatment of atrial fibrillation in patients with structural heart disease undergoing open-heart surgery. METHODS: The observed patient file consisted of 100 patients, who have undergone a combined open-heart surgery at our department between July 2012 and December 2014...
August 17, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28761039/atrio-esophageal-fistula-a-case-series-and-literature-review
#6
Craig A Schuring, Luke J Mountjoy, Ashley B Priaulx, Robert J Schneider, Hayden L Smith, Geoffrey C Wall, Dipen Kadaria, Amik Sodhi
BACKGROUND Percutaneous catheter radiofrequency ablation (RFA) and cryoablation of the left atrium and pulmonary vein ostia have become successful therapeutic modalities in the management of atrial fibrillation. Atrio-esophageal fistula is a rare complication. Awareness of complication risk is imperative because without prompt diagnosis and urgent surgical intervention, the outcome is often fatal. We present 3 cases of atrio-esophageal fistula following percutaneous catheter radiofrequency ablation (RFA). CASE REPORT Case 1: A 72-year old white male presented 27 days after percutaneous RFA for atrial fibrillation with fever, altered mental status, and melena...
August 1, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28738900/impact-of-ablation-duration-on-rhythm-outcome-after-concomitant-maze-procedure-using-cryoablation-in-patients-with-persistent-atrial-fibrillation
#7
Dong Seop Jeong, Ji Hoon You, Chang-Seok Jeon, Pyo Won Park, Kiick Sung, Wook Sung Kim, Young Tak Lee
BACKGROUND: The aim of this study was to evaluate the impact of ablation duration during a maze procedure using a nitrous oxide-based cryosurgical system. METHODS: From May 2001 to December 2006, 256 consecutive patients who underwent a concomitant maze procedure using nitrous oxide-based cryoablation for chronic atrial fibrillation (AF) during cardiac surgery were enrolled. The ablation duration for each lesion was between 120 s at -60 °C in 140 patients (control group) and 160 s in 116 patients (long duration group)...
July 24, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28706589/catheter-ablation-of-atrial-fibrillation-facilitated-by-preprocedural-three-dimensional-transesophageal-echocardiography-long-term-outcome
#8
Klaus Kettering, Felix Gramley, Stephan von Bardeleben
AIM: To evaluate the long-term outcome of catheter ablation of atrial fibrillation (AF) facilitated by preprocedural three-dimensional (3-D) transesophageal echocardiography. METHODS: In 50 patients, 3D transesophageal echocardiography (3D TEE) was performed immediately prior to an ablation procedure (paroxysmal AF: 30 patients, persistent AF: 20 patients). The images were available throughout the ablation procedure. Two different ablation strategies were used. In most of the patients with paroxysmal AF, the cryoablation technique was used (Arctic Front Balloon, CryoCath Technologies/Medtronic; group A2)...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28652028/cryoablation-for-atrial-fibrillation-in-2017-what-have-we-learned
#9
REVIEW
Padmanabhan Shakkottai, Raymond W Sy, Mark A McGuire
Catheter ablation has become a standard technique for the treatment of atrial fibrillation. Pulmonary vein isolation (PVI) is the most important component of catheter ablation of atrial fibrillation. Radiofrequency (RF) ablation and balloon cryoablation can be used to achieve PVI. This review examines the biophysics and clinical efficacy of balloon cryoablation and discusses the potential advantages and disadvantages compared to RF ablation.
May 26, 2017: Heart, Lung & Circulation
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
#10
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: The purpose of this study was to develop and prospectively test 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, nonstandardized approach (Cryo-AFConventional; n = 400) in a nonrandomized fashion...
September 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
#11
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
#12
Keith Suarez, Javier E Banchs, Hae W Lim, James N Black
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
#13
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
#14
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
#15
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...
August 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
#16
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
#17
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
#18
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
#19
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...
October 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
#20
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
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