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Cryoballoon ablation

Jeremiah Wasserlauf, Bradley P Knight, Zhi Li, Adin-Cristian Andrei, Rishi Arora, Alexandru B Chicos, Jeffrey J Goldberger, Susan S Kim, Albert C Lin, Nishant Verma, Martha M Bohn, Rod S Passman
BACKGROUND: Cryoballoon ablation (CBA) for paroxysmal atrial fibrillation (pAF) can be performed under general anesthesia (GA) or moderate sedation (MS). Our objective was to compare the effectiveness, safety, procedure duration, and time spent in the electrophysiology (EP) laboratory for CBA performed under GA and MS. METHODS: . Patients undergoing a first CBA for pAF were identified. Patients received either GA administered by an anesthesiologist or MS with midazolam and fentanyl administered by EP laboratory staff...
October 17, 2016: Pacing and Clinical Electrophysiology: PACE
Sergio Conti, Massimo Moltrasio, Claudio Tondo, Gaetano Fassini
Cryoballoon ablation is a widely diffuse technology to perform paroxysmal atrial fibrillation ablation. The new generation cryoballoon catheters have been redesigned in order to improve the cooling capability. During cryoballoon ablation it is not unusual to observe the formation of a contrast dye ice-cap on top of the balloon itself. The automated balloon deflation before dissolution of the ice cap may increase the risk of embolization of large ice-mixed-contrast crystals in the systemic circulation. In the case hereby reported, we describe an uneventful embolization of this contrast dye ice cap in the systemic circulation...
October 17, 2016: Pacing and Clinical Electrophysiology: PACE
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
Yasunori Kanzaki, Yasuya Inden, Monami Ando, Yosuke Kamikubo, Tadahiro Ito, Yoshiaki Mizutani, Hiroyuki Kato, Aya Fujii, Satoshi Yanagisawa, Makoto Hirai, Toyoaki Murohara
BACKGROUNDS: Although several prognostic factors of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) have been investigated, the accurate prediction of AF recurrence remains difficult. We propose an ECG index, the P-wave force (PWF), which is the product of the amplitude of the negative terminal phase of the P-wave in the V1 electrode and the filtered P-wave duration (FPD), obtained by a signal-averaged P-wave analysis. This study was conducted to evaluate the impact of the PWF on the recurrence of AF after PVI...
October 10, 2016: Pacing and Clinical Electrophysiology: PACE
Alessandra Buiatti, Gesa von Olshausen, Petra Barthel, Simon Schneider, Armin Luik, Bernhard Kaess, Karl-Ludwig Laugwitz, Petra Hoppmann
AIMS: Radiofrequency (RF) ablation represents a standard of care for pulmonary vein isolation in patients with drug-refractory paroxysmal atrial fibrillation (AF). In this setting, cryoballoon (CB) ablation has emerged as alternative therapy. However, the efficacy and safety of CB vs. RF ablation in patients with paroxysmal AF remain a matter of debate. METHODS AND RESULTS: We searched electronic scientific databases for studies of CB vs. RF ablation in patients with paroxysmal AF...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Tomofumi Nakamura, Kaoru Okishige, Toshiro Kanazawa, Mitsumi Yamashita, Naohiko Kawaguchi, Nobutaka Kato, Hideshi Aoyagi, Yasuteru Yamauchi, Tetsuo Sasano, Kenzo Hirao
AIMS: Pulmonary vein (PV) isolation (PVI) utilizing a cryoballoon (CB) has become one of the standard therapeutic options for atrial fibrillation (AF). However, it connotes a potential risk of cerebral ischaemic events (CIEs). This study aimed to clarify the prevalence of CIEs after PVI using second-generation CBs assessed by magnetic resonance imaging (MRI) of the brain. METHODS: This prospective observational study consisted of 160 patients that underwent PVI with second-generation CBs for drug-refractory AF...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Vincent Galand, Dominique Pavin, Nathalie Behar, Vincent Auffret, Damien Fénéon, Albin Behaghel, Jean-Claude Daubert, Philippe Mabo, Raphaël P Martins
BACKGROUND: Pulmonary vein (PV) isolation, using cryoballoon or radiofrequency ablation, is the cornerstone therapy for symptomatic paroxysmal atrial fibrillation (AF) refractory to antiarrhythmic drugs. One-third of the patients have recurrences, mainly due to PV reconnections. AIMS: To describe the different locations of reconnection sites in patients who had previously undergone radiofrequency or cryoballoon ablation, and to compare the characteristics of the redo procedures in both instances...
September 28, 2016: Archives of Cardiovascular Diseases
Jingbo Jiang, Jinyi Li, Guoqiang Zhong, Junjun Jiang
PURPOSE: Currently, radiofrequency (RF) and cryoballoon are the most commonly used ablation technologies for atrial fibrillation (AF). We performed a meta-analysis to assess the efficacy and safety of the second-generation cryoballoons (CB-2) compared with RF for paroxysmal atrial fibrillation (PAF) ablation. METHODS: The PubMed, Cochrane Library, and Embase databases were searched and qualified studies were identified. The primary clinical outcome was the recurrence rate of atrial tachyarrhythmia (AT), and the secondary clinical outcomes were procedure time, fluoroscopy time, and the complications that followed...
September 28, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Allan Davies, Prasad Gunaruwan, Nicholas Collins, Malcolm Barlow, Nick Jackson, James Leitch
PURPOSE: Pulmonary vein isolation using cryoballoon ablation is an established approach to treating atrial fibrillation. The procedure involves insertion of a 15-Fr sheath into the left atrium across the interatrial septum. This creates an iatrogenic atrial septal defect, which may have important long-term clinical relevance, especially in younger patients. We sought to determine the long-term incidence of these defects and determine the direction of shunt using contrast transesophageal echocardiography...
September 28, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Jeffrey J Goldberger, Raul D Mitrani
No abstract text is available yet for this article.
September 28, 2016: Journal of Cardiovascular Electrophysiology
Alexander Pott, Marvin Messemer, Kerstin Petscher, Mario Iturbe-Orbe, Carlo Bothner, Wolfgang Rottbauer, Tillman Dahme
BACKGROUND: Pulmonary vein isolation is an established therapy for symptomatic atrial fibrillation. Despite the fact that incidence and prevalence of atrial fibrillation increases with age, patients over 75 years of age have been excluded in all major atrial fibrillation ablation trials. Pulmonary vein isolation with the cryoballoon has been shown to be equally effective compared to irrigated radiofrequency catheter ablation, but patients over 75 years have also been excluded. The 2nd generation cryoballoon has shown superior efficacy compared to the 1st generation cryoballoon...
September 17, 2016: Journal of Cardiology
Petra Maagh, Gunnar Plehn, Arnd Christoph, Ahmet Oernek, Axel Meissner
Background: Atrial fibrillation (AF) represents a turning point in hypertrophic cardiomyopathy (HCM). Pulmonary Vein Isolation (PVI) with Radiofrequency Catheter Ablation (RFCA) is accepted to be successful in restoring sinus rhythm (SR) in HCM patients. The efficacy of cryoballoon (CB) therapy in HCM patients has not been studied so far. Methods: 166 patients with AF underwent PVI with CB technology in our single center between 1/2012 and 12/2015. To evaluate the efficacy of the CB therapy in HCM patients, we compared their clinical outcome with those in "Non-HCM" AF patients in a 3 and 6 months follow-up...
2016: International Journal of Medical Sciences
Jonathan S Zipursky, Steven Shadowitz
No abstract text is available yet for this article.
September 15, 2016: New England Journal of Medicine
Rui Providência, Pier D Lambiase, Eloi Marijon
No abstract text is available yet for this article.
September 15, 2016: New England Journal of Medicine
Karl‑Heinz Kuck, Josep Brugada, Jean‑Paul Albenque
No abstract text is available yet for this article.
September 15, 2016: New England Journal of Medicine
Hugo Enrique Coutiño, Carlo de Asmundis, Giacomo Mugnai, Darragh Moran, Valentina De Regibus, Erwin Ströker, Ken Takarada, Diego Ruggiero, Rajin Choudhury, Stefan Beckers, Carla Van Gompel, Jan Poelaert, Saverio Iacopino, Pasquale Filannino, Pedro Brugada, Gian-Battista Chierchia
PURPOSE: Data indicate that the second-generation cryoballoon (Arctic Front Advance, Medtronic, Minnesota, USA) could be effective for persistent atrial fibrillation. However, electrophysiological findings and the midterm clinical outcome of repeat procedures following second-generation cryoballoon ablation are lacking. METHODS: Consecutive patients with drug-resistant persistent atrial fibrillation who underwent a repeat ablation due to arrhythmia recurrence following an index procedure with second-generation cryoballoon were retrospectively included in our analysis...
August 25, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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
Shinsuke Miyazaki, Hitoshi Hachiya, Hiroaki Nakamura, Hiroshi Taniguchi, Takamitsu Takagi, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: The second-generation cryoballoon has been recently introduced into clinical use for pulmonary vein isolation (PVI). Data on the feasibility, long-term outcome, and optimal freeze cycle are still limited. We assessed the 1-year clinical outcome after second-generation CB ablation with single 3-minute freeze techniques, and clinical variables associated with AF recurrence. METHODS: One hundred eight paroxysmal atrial fibrillation (PAF) patients undergoing cryothermal PVI were enrolled...
August 18, 2016: Journal of Cardiovascular Electrophysiology
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