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cryoablation in persistent atrial fibrillation

Shiwei Huang, Binglin Pan, He Zou, Wei Lin
BACKGROUND: Atrial fibrillation (AF) usually originates from pulmonary veins (PVs) but can also be caused by pulmonary veins outside, such as the coronary sinus (CS), the superior vena cava (SVC), and the ligament of Marshall. CASE PRESENTATION: A 69-year-old male with a history of palpitations for 10 years was referred to our institute because of its recurrence for half a day. A dynamic electrocardiogram revealed sinus rhythm (SR) and paroxysmal AF. Echocardiography demonstrated normal cardiac structure, and physical examination results were unremarkable...
March 13, 2018: BMC Cardiovascular Disorders
Duygu Kocyigit, Muhammed Ulvi Yalcin, Kadri Murat Gurses, Selin Ardali, Gamze Turk, Ugur Canpolat, Banu Evranos, Hikmet Yorgun, Tuncay Hazirolan, Kudret Aytemir
AIMS: Several studies have investigated the influence of pulmonary vein(PV) anatomy on outcomes of atrial fibrillation (AF) ablation. We aimed to evaluate the relationship between PV orientation and AF-free survival following cryoablation. METHODS: 160 patients scheduled for cryoablation between September 2012-March 2014 were included. Patients underwent a pre-procedural cardiac CT scan with retrospective ECG gating. PV orientation was assessed according to the position of the PV orifice relative to the sagittal plane with reference to coronal and horizontal planes...
February 19, 2018: Journal of Cardiovascular Computed Tomography
Shohreh Honarbakhsh, Ben O'Brien, Richard J Schilling
Background: Trans-septal puncture (TSP) is routinely performed during treatment of atrial fibrillation (AF) and other electrophysiology procedures. The purpose of this retrospective observational study was the analysis of a novel needle free technique employed to gain access to the left atrium (LA). Methods: The SafeSept Needle Free guidewire was delivered, using no needle, to the interatrial septum via a standard cryoablation sheath and dilator under transoesophageal guidance...
August 2017: Journal of Atrial Fibrillation
Thomas Beiert, Pia C Lodde, Lutz P T Linneborn, Jessica Werner, Lisa Prinz, Florian Stöckigt, Markus Linhart, Lars Lickfett, Georg Nickenig, Jan W Schrickel, René P Andrié
BACKGROUND: Pulmonary vein isolation (PVI) has become a widely accepted therapy in patients suffering from symptomatic atrial fibrillation (AF). HYPOTHESIS: AF-free survival differs in patients with left common pulmonary vein (LCPV) after PVI with second-generation cryoballoon. METHODS: We included patients scheduled for first PVI for paroxysmal or persistent AF. Symptomatic and/or documented arrhythmia episodes (>30 seconds) were defined as AF recurrence, excluding a 3-month blanking period...
January 2018: Pacing and Clinical Electrophysiology: PACE
Jorge Romero, Andrea Natale, Luigi Di Biase
The role of pulmonary vein isolation in patients with non-paroxysmal atrial fibrillation (AF) is only modest. Several studies have demonstrated the role of the left atrial appendage (LAA) in initiating and maintaining of this arrhythmia. We review in this article the incremental benefit in free-arrhythmia recurrence of LAA electrical isolation in patients undergoing procedures for persistent AF or long standing persistent AF either using radiofrequency ablation, cryoablation or Lariat device implantation. Likewise, acute complications, anticoagulation and the risk of ischemic stroke after LAA electrical isolation (LAAEI) are analyzed...
November 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Serge Boveda
Pulmonary vein isolation is the cornerstone of atrial fibrillation ablation and is effective for preventing arrhythmias recurrences, especially in patients with paroxysmal atrial fibrillation. During the last years, cryoballoon ablation has emerged as an unquestionable alternative approach to radiofrequency ablation. Many non-randomized and randomized trials have proven undoubtedly that cryoballoon ablation displays similar efficacy and overall safety profile, when compared to radiofrequency ablation for the treatment of patients with drug-refractory paroxysmal atrial fibrillation...
November 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Claudio Tondo, Saverio Iacopino, Paolo Pieragnoli, Giulio Molon, Roberto Verlato, Antonio Curnis, Maurizio Landolina, Giuseppe Allocca, Giuseppe Arena, Gaetano Fassini, Luigi Sciarra, Mario Luzi, Massimiliano Manfrin, Luigi Padeletti
BACKGROUND: Pulmonary vein isolation (PVI) is a cornerstone ablation strategy in the management of patients with atrial fibrillation (AF). Consensus guidelines and statements recommend PVI during the index catheter ablation procedure in patients with paroxysmal and persistent AF. OBJECTIVE: The objective of this analysis was to evaluate patients with persistent and long-standing persistent AF who were treated with the cryoballoon ablation catheter by PVI technique...
March 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Dawid Miśkowiec, Jarosław D Kasprzak, Paulina Wejner-Mik, Ewa Szymczyk, Haval D Qawoq, Paweł Życiński, Tomasz Wcisło, Piotr Pagórek, Karolina Kupczyńska, Piotr Lipiec
BACKGROUND: Cryoballoon ablation for atrial fibrillation (cryoAF) is relatively simple, cost-effective and easy procedure. However, general anesthesia during this procedure may have negative impact on patients mortality and morbidity, as well as procedure costs. AIM: We sought to assess the feasibility and safety of conscious sedation during cryoAF. METHODS: Patients (pts) with paroxysmal or persistent, drug-refractory AF who underwent a first procedure of cryoAF were included in our single-center, retrospective study...
October 25, 2017: Minerva Cardioangiologica
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
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
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
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
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...
June 2017: Herzschrittmachertherapie & Elektrophysiologie
Hacı Murat Güneş, Gamze Babur Güler, Ekrem Güler, Gültekin Günhan Demir, Filiz Kızılırmak Yılmaz, Mehmet Onur Omaygenç, Ayşe İstanbullu Tosun, Taylan Akgün, Bilal Boztosun, Fethi Kılıçarslan
OBJECTIVE: Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with increased morbidity and mortality. Atrial fibrosis augments recurrence rate following AF catheter ablation. Osteopontin is a multifunctional molecule involved in several pathophysiological pathways, including fibrosis. Presently described is investigation of relationship between serum osteopontin level and AF recurrence after AF cryoablation. METHODS: The study was designed to be prospective and observational; 60 patients with paroxysmal (n=47) and persistent (n=13) AF were included...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
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
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...
July 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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...
December 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
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