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cryoablation in persistent atrial fibrillation

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https://www.readbyqxmd.com/read/27832044/early-results-of-the-modified-right-atrial-lesion-set-for-the-cox-cryomaze-procedure
#1
Faisal Habib Cheema, Muhammad Amir Younus, Osama T Siddiqui, Muhammad Jabran Younus, Muhammad Arif Mahmood, Mohammad Bin Pervez, Harold G Roberts
OBJECTIVE: The standard right atrial lesion (RAL) set, as originally outlined in the Cox-Maze III procedure, can be technically challenging when using a cryoprobe to create the lesions. We report our initial experience with an alternative set of RALs for the surgical treatment of atrial fibrillation (AF). METHODS: Between September 2011 and January 2015, a total of 112 patients underwent a CryoMaze procedure with biatrial lesions using argon-based cryoablation (cryoprobe temperature, -160°C)...
September 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27738068/cryoballoon-ablation-of-persistent-atrial-fibrillation-feasibility-and-safety-of-left-atrial-roof-ablation-with-generation-of-conduction-block-in-addition-to-antral-pulmonary-vein-isolation
#2
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
https://www.readbyqxmd.com/read/27503480/catheter-ablation-using-the-third-generation-cryoballoon-provides-an-enhanced-ability-to-assess-time-to-pulmonary-vein-isolation-facilitating-the-ablation-strategy-short-and-long-term-results-of-a-multicenter-study
#3
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 exist on cryoablation of atrial fibrillation (Cryo-AF) using the newly available third-generation (Arctic Front Advance-Short Tip [AFA-ST]) cryoballoon. OBJECTIVE: In this multicenter study, we evaluated the safety and efficacy of Cryo-AF using the AFA-ST vs the second-generation (Arctic Front Advance [AFA]) cryoballoon. METHODS: We examined the procedural safety and efficacy and the short- and long-term clinical outcomes associated with a first-time Cryo-AF performed in 355 consecutive patients (254/355 [72%] with paroxysmal AF), using either the AFA-ST (n = 102) or the AFA (n = 253) cryoballoon catheters...
August 5, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27390961/durability-of-cryothermal-pulmonary-vein-isolation-creating-contiguous-lesions-is-necessary-for-persistent-isolation
#4
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
https://www.readbyqxmd.com/read/27354860/impact-of-transesophageal-echocardiography-during-transseptal-puncture-on-atrial-fibrillation-ablation
#5
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
https://www.readbyqxmd.com/read/27294840/cryoablation-in-persistent-atrial-fibrillation-a%C3%A2-critical-appraisal
#6
REVIEW
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
https://www.readbyqxmd.com/read/27111318/is-achievement-of-pulmonary-vein-isolation-the-only-effect-of-cryoballoon-ablation-in-long-standing-persistent-atrial-fibrillation
#7
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
https://www.readbyqxmd.com/read/26960034/atrial-fibrillation-management-evaluating-rate-vs-rhythm-control
#8
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
https://www.readbyqxmd.com/read/26681608/german-ablation-registry-cryoballoon-vs-radiofrequency-ablation-in-paroxysmal-atrial-fibrillation-one-year-outcome-data
#9
Martin Schmidt, Uwe Dorwarth, Dietrich Andresen, Johannes Brachmann, Karlheinz Kuck, Malte Kuniss, Stephan Willems, Thomas Deneke, Jürgen Tebbenjohanns, Jin-Hong Gerds-Li, Stefan Spitzer, Jochen Senges, Matthias Hochadel, Ellen Hoffmann
BACKGROUND: Although radiofrequency (RF) ablation has long been the standard of care for atrial fibrillation (AF) ablation, cryoballoon technology has emerged as a feasible approach with promising results. Prospective multicenter registry data referring to both ablation technologies in AF ablation are lacking so far. OBJECTIVE: The purpose of this study was to report data from the German ablation registry with respect to efficacy and safety in pulmonary vein ablation with different energy sources for paroxysmal AF after 1-year follow-up...
April 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/26564954/phrenic-nerve-injury-during-ablation-with-the-second-generation-cryoballoon-analysis-of-the-temperature-drop-behaviour-in-a-large-cohort-of-patients
#10
Giacomo Mugnai, Carlo de Asmundis, Vedran Velagic, Burak Hünük, Erwin Ströker, Kristel Wauters, Ghazala Irfan, Ingrid Overeinder, Ebru Hacioglu, Jaime Hernandez-Ojeda, Jan Poelaert, Christian Verborgh, Gaetano Paparella, Pedro Brugada, Gian-Battista Chierchia
AIMS: The present study sought to analyse the relationship between the temperature drop during the cryoenergy application and the occurrence of phrenic nerve injury (PNI) in a large cohort of patients having undergone second-generation cryoballoon ablation (CB-A). METHODS AND RESULTS: The first 550 consecutive patients having undergone CB-A for atrial fibrillation were enrolled. Attained temperatures at 20, 30, 40, and 60 s during cryoablation in the right-sided pulmonary veins (PVs) were collected...
May 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/26549153/-biatrial-vs-isolated-left-atrial-cryoablation-for-the-treatment-of-long-lasting-permanent-atrial-fibrillation-midterm-recurrence-rate
#11
Javier Gualis, Mario Castaño, Jose Manuel Martínez-Comendador, Jose Miguel Marcos, Carlos Martín, Rodrigo Estévez-Loureiro, Jesús Gómez-Plana, Elio Martín, Javier Otero
UNLABELLED: The long-term results of cryomaze in patients with longstanding persistent atrial fibrillation during concomitant surgical procedures are still uncertain. METHODS: Between 2006 and 2011, 150 consecutive patients with associated long-lasting permanent atrial fibrillation and associated heart disease underwent heart surgery were treated by biatrial Cox-Maze (63 patients) or by isolated endocardial or epicardial left atrial cryoablation (83 patients) concomitantly...
April 2016: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/26362625/long-term-outcomes-after-surgical-ablation-for-atrial-fibrillation-in-patients-with-continuous-heart-rhythm-monitoring-devices
#12
Efstratios I Charitos, Paul D Ziegler, Ulrich Stierle, Bernhard Graf, Hans-Hinrich Sievers, Thorsten Hanke
OBJECTIVES: Surgical ablation for atrial fibrillation (AF) is an established therapy for the treatment of concomitant AF in cardiac surgery patients. We aim to present our prospective experience with 99 continuously monitored patients and investigate whether enhanced monitoring can identify patterns and factors influencing AF recurrence after surgical AF ablation. METHODS: Ninety-nine patients (73 males; age: 68.0 ± 9.2 years) with documented preoperative AF (paroxysmal: 29; persistent: 18; long-lasting persistent: 52, mean preoperative duration: 46 ± 53 months) underwent concomitant biatrial surgical ablation (Cox Maze III: 29), full set left atrial cryoablation (n = 22), high-intensity focused ultrasound (HIFU) box lesion (n = 46) or right-sided ablation (n = 2)...
December 2015: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/26212511/impact-of-atrial-fibrillation-duration-on-the-success-of-first-time-concomitant-cox-maze-procedures
#13
Niv Ad, Sari D Holmes, Deborah J Shuman, Graciela Pritchard
BACKGROUND: Atrial fibrillation (AF) duration is one of the most consistent predictors of Cox maze (CM) procedure failure. We examined the impact of AF duration on CM success in patients having first-time concomitant surgery. METHODS: First-time concomitant CM was performed in 505 patients. Freedom from atrial arrhythmia (AA) and class I/III antiarrhythmic drug (AAD) data were collected prospectively. Patients with longer AF duration (≥ 5 years; n = 113) were compared with shorter duration (<5 years; n = 392) in primary analyses...
November 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26172428/sequential-hybrid-surgical-cryomaze-and-transvenous-catheter-ablation-of-atrial-fibrillation
#14
Martin Eisenberger, Alan Bulava, Ales Mokracek, Jiri Hanis, Vojtech Kurfirst, Ladislav Dusek
BACKGROUND: The aim of the study was to evaluate whether the sequential hybrid approach combining surgical CryoMaze followed by the radiofrequency (RF) catheter ablation can improve freedom from atrial arrhythmias. METHODS: Thirty-five patients with persistent atrial fibrillation underwent a CryoMaze procedure in conjunction with cardiac surgery for structural heart disease. Three months after surgery, all patients underwent a 7-day electrocardiogram Holter followed by an electrophysiological study and mapping of the left and right atria...
December 2015: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/25735737/history-and-development-of-surgical-procedures-for-atrial-fibrillation
#15
REVIEW
Taijiro Sueda
Cox J.L. devised the Maze procedure as a radical procedure for treating lone atrial fibrillation (AF) based on the multiple re-entry theory proposed by Allessie M.A. recently, Damiano R.J. devised the Cox Maze IV procedure using a bipolar radiofrequency clamp instead of cut-and-sew lines in 2008. In Japan, Kosakai Y. modified the original Maze II procedure using cryoablation in place of cut-and-sew lines in 1994, and Sueda T. reported the efficacy of the left atrial Maze procedure for persistent AF associated with mitral valve disease in 1996...
December 2015: Surgery Today
https://www.readbyqxmd.com/read/25510648/red-blood-cell-distribution-width-predicts-outcome-of-cryoballoon-based-atrial-fibrillation-ablation
#16
Kadri Murat Gurses, Muhammed Ulvi Yalcin, Duygu Kocyigit, Banu Evranos, Ahmet Hakan Ates, Hikmet Yorgun, Mehmet Levent Sahiner, Ergun Baris Kaya, Necla Ozer, Mehmet Ali Oto, Kudret Aytemir
PURPOSE: Elevated red blood cell distribution width (RDW) has been associated with atrial fibrillation (AF) in cross-sectional and prospective studies. In this study, we aim to evaluate the relation of preablation RDW levels to late AF recurrence following cryoablation. METHODS: A total of 299 patients with symptomatic paroxysmal or persistent AF despite ≥ 1 antiarrhythmic drug(s) who were scheduled for cryoballoon-based AF ablation were enrolled in this prospective study...
January 2015: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/25446159/reduced-incidence-of-esophageal-lesions-by-luminal-esophageal-temperature-guided-second-generation-cryoballoon-ablation
#17
COMPARATIVE STUDY
Alexander Fürnkranz, Stefano Bordignon, Michael Böhmig, Athanasios Konstantinou, Daniela Dugo, Laura Perrotta, Tom Klopffleisch, Bernd Nowak, Axel U Dignaß, Boris Schmidt, Julian K R Chun
BACKGROUND: An increased incidence of esophageal lesions (EL) after pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB2) has been described. We hypothesized that luminal esophageal temperature (LET)-guided PVI reduces the incidence of EL. OBJECTIVE: The aim of this study was to investigate the incidence of EL after LET-guided PVI using the CB2. METHODS: Ninety-four consecutive patients underwent CB2-PVI for paroxysmal or persistent atrial fibrillation...
February 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/25060723/interventional-treatment-of-atrial-fibrillation-contemporary-methods-and-perspectives
#18
Bartosz Zuchowski, Krzysztof Kaczmarek, Lukasz Szumowski, Yi-Gang Li, Pawel Ptaszynski
Atrial fibrillation (AF) is estimated to affect nearly 3 million people around the world. It is the most common arrhythmia and its incidence increases with age. Catheter ablation is an interventional procedure performed to reduce the patient's AF burden when pharmacotherapy did not succeed in relieving the patient's symptoms. The ablation is most effective in paroxysmal AF; however, many techniques are being developed to make this procedure more eligible for patients with persistent arrhythmia. The most common AF ablation technique involves separating electric activity of the pulmonary veins from the left atrium...
November 2014: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/25017398/clinical-experience-with-a-novel-electromyographic-approach-to-preventing-phrenic-nerve-injury-during-cryoballoon-ablation-in-atrial-fibrillation
#19
Blandine Mondésert, Jason G Andrade, Paul Khairy, Peter G Guerra, Katia Dyrda, Laurent Macle, Léna Rivard, Bernard Thibault, Mario Talajic, Denis Roy, Marc Dubuc, Azadeh Shohoudi
BACKGROUND: Phrenic nerve palsy remains the most frequent complication associated with cryoballoon-based pulmonary vein (PV) isolation. We sought to characterize our experience using a novel monitoring technique for the prevention of phrenic nerve palsy. METHODS AND RESULTS: Two hundred consecutive cryoballoon-based PV isolation procedures between October 2010 and October 2013 were studied. In addition to standard abdominal palpation during right phrenic nerve pacing from the superior vena cava, all patients underwent diaphragmatic electromyographic monitoring using surface electrodes...
August 2014: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/24582049/prospective-assessment-of-the-cryomaze-procedure-with-continuous-outpatient-telemetry-in-136-patients
#20
A Claire Watkins, Cindi A Young, Mehrdad Ghoreishi, Stephen R Shorofsky, Joel Gabre, Murtaza Y Dawood, Bartley P Griffith, James S Gammie
BACKGROUND: Only 40% of patients with atrial fibrillation (AF) undergoing cardiac surgery are treated with surgical AF correction. We prospectively studied endocardial cryoablation of the Cox-maze III lesion set following prespecified rhythm assessment with outpatient telemetry. METHODS: Between 2007 and 2011, 136 patients underwent surgical AF correction using an argon-powered cryoablation device. Patients wore continuous electrocardiogram monitoring prior to and at 6, 12, and 24 months after surgery...
April 2014: Annals of Thoracic Surgery
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