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Cryoballoon ablation

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https://www.readbyqxmd.com/read/29759431/anatomic-parameters-predicting-procedural-difficulty-and-balloon-temperature-predicting-successful-applications-in-individual-pulmonary-veins-during-28-mm-second-generation-cryoballoon-ablation
#1
Takatsugu Kajiyama, Shinsuke Miyazaki, Junji Matsuda, Tomonori Watanabe, Takayuki Niida, Takamitsu Takagi, Hiroaki Nakamura, Hiroshi Taniguchi, Hitoshi Hachiya, Yoshito Iesaka
OBJECTIVES: This study sought to identify anatomic parameters predicting procedural difficulty in achieving pulmonary vein isolation (PVI) and in-procedural predictors of successful applications during second-generation cryoballoon (CB) ablation. BACKGROUND: PV anatomies vary and influence the procedural difficulty during CB PVI. METHODS: In total, 408 initial freezes among 110 patients undergoing PVI for paroxysmal atrial fibrillation using 28-mm second-generation CBs with single 3-min freeze techniques were included...
June 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29741689/cryoballoon-ablation-in-the-elderly-one-year-outcome-and-safety-of-the-second-generation-28mm-cryoballoon-in-patients-over-75-years-old
#2
Verena Tscholl, Tina Lin, Abdullah Khaled-A Lsharaf, Barbara Bellmann, Patrick Nagel, Klaus Lenz, Ulf Landmesser, Mattias Roser, Andreas Rillig
Aims: The efficacy of the second-generation cryoballoon (CB) ablation in patients with atrial fibrillation (AF) has been demonstrated previously. Data on the efficacy of CB ablation in elderly patients is missing. The aim of this study was to evaluate the long-term success rate of pulmonary vein isolation (PVI) in patients ≥75 years vs. <75 years using the second-generation 28mm CB. Methods and results: Eighty patients [n = 40 ≥75 years (Group 1); n = 40 <75 years (Group 2)] with paroxysmal [n = 37 (46%) or persistent (n = 43 (54%)] AF were included...
May 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29721503/radiofrequency-versus-cryoballoon-ablation-of-atrial-fibrillation-an-evaluation-using-ecg-holter-monitoring-and-implantable-loop-recorders-to-monitor-absolute-and-clinical-effectiveness
#3
Karapet Davtyan, Victoria Shatakhtsyan, Hermine Poghosyan, Alexandr Deev, Alexey Tarasov, Maria Kharlap, Svetlana Serdyuk, Georgy Simonyan, Sergey Boytcov
Introduction: While several studies have compared the radiofrequency current (RFC) and cryoablation for the treatment of patients with atrial fibrillation (AF), no study has monitored the long-term outcomes with the usage of implantable loop recorders (ILRs). Methods: We enrolled 89 consecutive patients with nonvalvular paroxysmal AF ( N = 44 for RFC and N = 45 for cryoballoon). The primary efficacy end point was the assessment of effectiveness for each group (RFC versus cryoballoon) when examining freedom from arrhythmia by monitoring with ECG, Holter, and implantable loop recoder (ILR)...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29700055/hot-balloon-versus-cryoballoon-ablation-for-atrial-fibrillation-lesion-characteristics-and-middle-term-outcomes
#4
Koichi Nagashima, Yasuo Okumura, Ichiro Watanabe, Shiro Nakahara, Yuichi Hori, Kazuki Iso, Ryuta Watanabe, Masaru Arai, Yuji Wakamatsu, Sayaka Kurokawa, Hiroaki Mano, Toshiko Nakai, Kimie Ohkubo, Atsushi Hirayama
BACKGROUND: Hot balloon ablation (HBA) and cryoballoon ablation (CBA) were developed to simplify ablation for atrial fibrillation. Because the lesion characteristics and efficacy of these balloon modalities have not been clarified, we compared lesion characteristics and outcomes of HBA and CBA. METHODS: Of 165 consecutive patients who underwent initial catheter ablation for atrial fibrillation, 74 propensity scorematched (37 HBA and 37 CBA) patients were included in our study...
May 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29686870/practical-techniques-in-cryoballoon-ablation-how-to-isolate-inferior-pulmonary-veins
#5
Shaojie Chen, Boris Schmidt, Stefano Bordignon, Fabrizio Bologna, Takahiko Nagase, Laura Perrotta, K R Julian Chun
Catheter ablation is the most effective treatment option for patients suffering from symptomatic atrial fibrillation. Electrical isolation of the pulmonary veins is the procedural cornerstone. Point-by-point radiofrequency current energy ablation in combination with a 3D electro-anatomical mapping system is the established approach to ablation. In contrast, cryoballoon ablation uses a single-shot approach to facilitate pulmonary vein isolation. However, fixed cryoballoon diameters (28 mm or 23 mm) and non-balloon compliance can lead to technical difficulties in isolating variable pulmonary vein anatomies...
March 2018: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29684571/cryoballoon-best-practices-ii-practical-guide-to-procedural-monitoring-and-dosing-during-atrial-fibrillation-ablation-from-the-perspective-of-experienced-users
#6
Wilber Su, Arash Aryana, Rod Passman, Gurjit Singh, Robert Hokanson, Marcin Kowalski, Jason Andrade, Paul Wang
Since cryoballoon was evaluated in STOP-AF, over 350,000 patients with AF have been treated. Several studies have reported improved outcomes using the second-generation cryoballoon, and recent publications have evaluated modifications, refinements, and improvements to procedural techniques. Here, peer-reviewed manuscripts published since the first cryoballoon best practices review were summarized against the technical practices of physicians with a high-level of experience with the cryoballoon (average ≥6 years of experience in ≥900 cases)...
April 20, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29684171/life-threatening-pulmonary-haemorrhage-during-cryoballoon-ablation-for-atrial-fibrillation
#7
Michael Schweigert, Ana Beatriz Almeida
Cryoballoon ablation is a recently introduced treatment option for patients with symptomatic, drug-refractory atrial fibrillation. The rate of complications is low and comprises mainly vascular-access-site complications and phrenic nerve palsy. We report a case of life-threatening pulmonary haemorrhage occurring during the procedure.
April 18, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29679186/impact-of-an-additional-right-pulmonary-vein-on-second-generation-cryoballoon-ablation-for-atrial-fibrillation-a-propensity-matched-score-study
#8
Ken Takarada, Erwin Ströker, Juan-Pablo Abugattas, Valentina de Regibus, Hugo-Enrique Coutiño, Ian Lusoc, Lucio Capulzini, Juan Sieira, Giacomo Mugnai, Francesca Salghetti, Rajin Choudhury, Saverio Iacopino, Carlo de Asmundis, Pedro Brugada, Gian-Battista Chierchia
PURPOSE: Cryoballoon (CB) technology in the context of anatomical pulmonary vein (PV) variants might hypothetically hamper successful PV isolation (PVI). Our aim was to assess the impact of a right middle PV (RMPV) in the setting of second-generation cryoballoon (CB advance-CB-A), on procedural parameters and on mid-term follow-up. METHODS: Consecutive patients with AF presenting RMPV (RMPV+) at the pre-procedural computed tomography who underwent PVI by CB-A were enrolled...
April 21, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29679185/comparing-learning-curves-of-two-established-single-shot-devices-for-ablation-of-atrial-fibrillation
#9
Patrick Leitz, G Mönnig, F Güner, D G Dechering, K Wasmer, F Reinke, Philipp S Lange, L Eckardt, G Frommeyer
PURPOSE: We compared the contour of learning curves of two "single-shot" devices used for pulmonary vein isolation (PVI) for safety and procedural data. METHODS: We performed a retrospective analysis comparing the first 60 PVI performed at our center using a pulmonary vein ablation catheter (PVAC) array (39 male, mean age 57 years, 42 paroxysmal AF) to the first 60 first PVI using the Cryoballoon (44 male, mean age 59 years, 22 paroxysmal AF). Both groups were further divided into tertiles, where T1 regroups the first 20 ablations, T2 the following 20, and T3 the last 20 ablations...
April 20, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29663562/atrial-fibrillation-ablation-using-cryoballoon-technology-recent-advances-and-practical-techniques
#10
REVIEW
Shaojie Chen, Boris Schmidt, Stefano Bordignon, Fabrizio Bologna, Laura Perrotta, Takahiko Nagase, K R Julian Chun
Atrial fibrillation (AF) affects 1-2% of the population, and its prevalence is estimated to double in the next 50 years as the population ages. AF results in impaired patients' life quality, deteriorated cardiac function and even increased mortality. Antiarrhythmic drugs frequently fail to restore sinus rhythm. Catheter ablation is a valuable treatment approach for AF, even as a first-line therapy strategy in selected patients. Effective electrical pulmonary vein isolation (PVI) is the cornerstone of all AF ablation strategies...
April 16, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29657591/the-lesion-characteristics-assessed-by-lge-mri-after-the-cryoballoon-ablation-and-conventional-radiofrequency-ablation
#11
Jun Kurose, Kunihiko Kiuchi, Koji Fukuzawa, Shumpei Mori, Hirotoshi Ichibori, Hiroki Konishi, Yayoi Taniguchi, Kiyohiro Hyogo, Hiroshi Imada, Hideya Suehiro, Yu-Ichi Nagamatsu, Tomomi Akita, Makoto Takemoto, Ken-Ichi Hirata, Shinsuke Shimoyama, Yoshiaki Watanabe, Tatsuya Nishii, Noriyuki Negi, Katsusuke Kyotani
Background: Rhythm outcomes after the pulmonary vein isolation (PVI) using the cryoballoon (CB) are reported to be excellent. However, the lesions after CB ablation have not been well discussed. We sought to characterize and compare the lesion formation after CB ablation with that after radiofrequency (RF) ablation. Methods: A total of 42 consecutive patients who underwent PVI were enrolled (29 in the CB group and 13 in the RF group). The PVI lesions were assessed by late gadolinium enhancement magnetic resonance imaging 1-3 months after the PVI...
April 2018: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29656325/dosing-of-the-second-generation-cryoballoon-using-acute-time-to-pulmonary-vein-isolation-as-an-indicator-of-durable-ablation-in-a-canine-model
#12
Wilber Su, Nicolas Coulombe, Nicole Kirchhof, Erin Grassl, Dan Wittenberger
BACKGROUND: Rigid time-based dosing protocol(s) currently used in the clinic for cryoballoon ablation of atrial fibrillation may be inadequate to guide the circumferential and transmural cryothermal energy transfer across the pulmonary vein (PV) and may result in injury to collateral tissues or electrical gaps between the PV and left atrium (LA). OBJECTIVE: A physiologic endpoint (e.g., acute time-to-PV isolation a.k.a. time-to-effect; TTE) may be effective in the determination of a transmural lesion formation and may allow for individualized ablation dosing across each PV...
April 14, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29626424/multifocal-nitrous-oxide-cryoballoon-ablation-with-or-without-emr-for-treatment-of-neoplastic-barrett-s-esophagus
#13
Marcia Irene Canto, Nicholas J Shaheen, Jose Alejandro Almario, Lysandra Voltaggio, Elizabeth Montgomery, Charles J Lightdale
BACKGROUND AND AIMS: Endoscopic cryotherapy can eradicate neoplastic Barrett's esophagus (BE). A new contact cryoballoon focal ablation system (CbFAS)) freezes esophageal mucosa with nitrous oxide. We studied the safety and efficacy of CbFAS for complete eradication of neoplastic Barrett's esophagus. METHODS: In a prospective clinical trial, consecutive BE patients with confirmed neoplasia (low-grade dysplasia LGD, high-grade dysplasia HGD, and/or intramucosal adenocarcinoma ImCA), at least 1 cm of BE, with or without prior ablation, were treated with a dose 10 seconds of spray per site...
April 4, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29618679/low-risk-of-pulmonary-vein-stenosis-after-contemporary-atrial-fibrillation-ablation-lessons-from-repeat-procedures-after-radiofrequency-current-cryoballoon-and-laser-balloon
#14
Takahiko Nagase, Stefano Bordignon, Laura Perrotta, Fabrizio Bologna, Felix K Weise, Athanasios Konstantinou, Ritsushi Kato, Boris Schmidt, Julian K R Chun
BACKGROUND: The incidence of pulmonary vein stenosis (PVS) after AF ablation following contemporary procedures remains unclear. We compared the incidence of PVS/narrowing (PVS/N) after PV isolation (PVI) for (1) 3-D mapping-guided wide-area encircling irrigated radiofrequency current (RFC) ablation; (2) first-third-generation big cryoballoon (CB1-3) ablation; and (3) laser balloon (LB) ablation.Methods and Results:All patients undergoing a second procedure between January 2012 and November 2016 were subgrouped according to index ablation (PVI): RFC; CB; or LB...
April 5, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29618477/characteristics-of-ice-impedance-recorded-from-a-ring-electrode-placed-at-the-anterior-surface-of-the-cryoballoon-novel-approach-to-define-ice-formation-and-pulmonary-vein-isolation
#15
Boaz Avitall, Arthur Kalinski, G Stephen Kocheril, Ken S Lizama, Nicolas Coulombe, Timothy Laske
BACKGROUND: The success of cryoablation of the pulmonary vein isolation (PVI) is dependent on transmural and circumferential ice formation. We hypothesize that rising impedance recorded from a ring electrode placed 2 mm from the cryoballoon signifies ice formation covering the balloon surface and indicates ice expansion. The impedance level enables titration of the cryoapplication time to avoid extracardiac damage while ensuring PVI. METHODS AND RESULTS: In 12 canines, a total of 57 pulmonary veins were targeted for isolation...
April 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29603755/impact-of-left-atrial-size-on-isolation-area-in-the-acute-phase-of-pulmonary-vein-isolation-using-28-mm-cryoballoon
#16
Akio Chikata, Takeshi Kato, Kazuo Usuda, Shuhei Fujita, Michiro Maruyama, Yoshiki Nagata, Satoru Sakagami, Naomi Kanamori, Takanori Yaegashi, Takahiro Saeki, Takashi Kusayama, Soichiro Usui, Hiroshi Furusho, Shuichi Kaneko, Masayuki Takamura
BACKGROUND: The impact of left atrial (LA) size on isolation area (ISA) using a 28-mm second-generation cryoballoon (CB) in the acute phase after pulmonary vein isolation (PVI) and the differences of CB from contact force-guided radiofrequency (RF) ablation have not been fully investigated. METHODS: We examined 85 consecutive patients (CB group, 35; RF group, 50) with drug-refractory paroxysmal atrial fibrillation who underwent their first PVI procedure at two institutions...
March 31, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29603258/-crosstalk-technique-a-comparison-between-two-generations-of-cryoballoon-catheter
#17
Jian-du Yang, Qi Sun, Xiao-Gang Guo, Gong-Bu Zhou, Xu Liu, Bin Luo, Hui-Qiang Wei, Jackson J Liang, Jian Ma
INTRODUCTION: The 'Crosstalk' technique- if pulmonary vein isolation (PVI) of the superior one is not achieved due to a gap in the inferior part, it could be done during inferior vein cryo-ablation. This maneuver while minimizing the total energy delivery time and number of lesions. We aimed to correlate the likelihood of crosstalk phenomenon with certain anatomic characteristics. METHODS: A total of 676 patients undergoing a first ablation procedure for paroxysmal or persistent AF (470 first-generation cryoballoon (CB) and 206 second-generation CB) between June 2014 and December 2016 were included...
March 30, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29601309/anatomical-and-procedural-predictors-of-pulmonary-vein-stenosis-in-the-setting-of-second-generation-cryoballoon-ablation
#18
Hugo-Enrique Coutiño, Ken Takarada, Juan Sieira, Juan-Pablo Abugattas, Francesca Salghetti, Valentina De Regibus, Erwin Ströker, Pedro Brugada, Saverio Iacopino, Carlo de Asmundis, Gian-Battista Chierchia
AIMS: Pulmonary vein stenosis (PVS) is a well recognized complication as a consequence of pulmonary vein isolation. In the current study, we sought to analyze potential anatomical and intraprocedural predictors of PVS during second-generation cryoballoon ablation, particularly focusing on the impact of freeze duration and number of cryoapplications. METHODS: Fifty-four patients who underwent cryoballoon ablation for atrial fibrillation were included retrospectively in this study...
March 29, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29600027/new-individualized-strategy-instructs-cryoballoon-energy-ablation
#19
EDITORIAL
Wei-Dong Lin, Xian-Hong Fang, Yu-Mei Xue, Hong-Tao Liao
No abstract text is available yet for this article.
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29579615/second-generation-cryoballoon-ablation-as-a-first-line-treatment-of-symptomatic-atrial-fibrillation-two-year-outcome-and-predictors-of-recurrence-after-a-single-procedure
#20
Ersan Akkaya, Alexander Berkowitsch, Sergej Zaltsberg, Harald Greiss, Christian W Hamm, Johannes Sperzel, Thomas Neumann, Malte Kuniss
INTRODUCTION: Antiarrhythmic drug (AAD) therapy of patients with atrial fibrillation (AF) has limitations. We investigated the 2-year outcome and pre-procedural predictors of recurrence for first-line catheter ablation using the second-generation cryoballoon (CB-Adv) in a large cohort of patients with symptomatic AF. METHODS AND RESULTS: For this prospective observational study, we enrolled 457 patients with symptomatic AF (278 paroxysmal, 179 persistent) who had no history of AAD use and who underwent pulmonary vein isolation (PVI) with the CB-Adv at our institution...
May 15, 2018: International Journal of Cardiology
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