scholarly journals Procedural and biophysical indicators of durable pulmonary vein isolation during cryoballoon ablation of atrial fibrillation

Heart Rhythm ◽  
2016 ◽  
Vol 13 (2) ◽  
pp. 424-432 ◽  
Author(s):  
Arash Aryana ◽  
Giacomo Mugnai ◽  
Sheldon M. Singh ◽  
Deep K. Pujara ◽  
Carlo de Asmundis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Cryoballoon Ablation ◽  
Biophysical Indicators

scholarly journals Clinical success of cryoballoon pulmonary vein isolation in patients with atrial fibrillation

2019 ◽  
Vol 7 (4S) ◽  
pp. 6-14
Author(s):  
T. Y. Chichkova ◽  
S. E. Mamchur ◽  
E. A. Khomenko
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Direct Current ◽  
Clinical Success ◽  
Persistent Atrial Fibrillation ◽  
Cryoballoon Ablation ◽  
Clinical Effects ◽  
Rf Ablation

Aim. To estimate the clinical success of cryoballoon pulmonary vein isolation (PVI).Methods.230 patients (males: 49.6%, mean age 57 (53; 62) with symptomatic paroxysmal and persistent atrial fibrillation (AF) resistant to antiarrhythmic therapy were included in a single-center prospective study. The patients were randomized into 2 groups to undergo either cryoballoon ablation (n = 122) or radiofrequency (RF) (n = 108) ablation. Both groups were comparable in baseline parameters. The follow-up period was 12 months. Clinical outcomes were estimated with the use of a three-stage scale. The rates of cardiovascular rehospitalizations, direct-current cardioversions and repeated ablations during were estimated within the follow-up. The quality of life (QoL) in the cryoablation group was measured using the AFEQT scale.Results.77% (n = 94) of patients in the cryoballoon ablation group and 71.3% (n = 77) of patients in the RF group (р = 0.71) demonstrated reported the optimal clinical effects. Both groups, cryo ablation and RF ablation, had similar rates of cardiovascular hospitalizations (23.8 vs 28.7%, OR 0.8, 95% CI 0.4–1.4; р = 0.39), direct-current cardioversions (12.3 vs 17.6%, OR 0.7, 95% CI 0.3–1.4; р = 0.26) and repeated ablations (9.8–11.1%, OR 0.9, 95% CI 0.4–2.0; р = 0.75). The patients treated with cryoballoon as opposed to RF ablation had significantly more successful usage of “pill-in-pocket” strategy – 14.8 vs 6.5% (OR 2.5, 95% CI 1.01–6.2; р = 0.04). Significant improvements of the QoL parameters with strong size effect have been found in the cryoablation group, i.e. global score (GS) increased by 8.9±6.9 (95% CI 6.6–10.1; dCohen 1.2; р<0.001), symptoms (S) – by 8.3±7.9 (95% CI 4.2–8.8; dCohen 1.5; р<0.001), daily activities (DA) – by 10.0±6.9 (95% CI = 6.4–10.6; dCohen 0.9; р<0.001), treatment concerns (TC) – by 5.5±6.0 (95% CI 6.3–9.2; dCohen 1.2; р<0.001) and treatment satisfaction (TS) – by 5.5±6.0 (95% CI 5.4–9.8; dCohen 0.9; р<0.001).Conclusion.The both catheter-based technologies had comparable clinical success. Cryoablation was characterized by improvement in all QoL parameters based on the AFEQT score.

scholarly journals Procedural Patterns and Safety of Atrial Fibrillation Ablation

2020 ◽  
Vol 13 (9) ◽  
Author(s):  
Zak Loring ◽  
DaJuanicia N. Holmes ◽  
Roland A. Matsouaka ◽  
Anne B. Curtis ◽  
John D. Day ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Contact Force ◽  
De Novo ◽  
Class I ◽  
Cryoballoon Ablation ◽  
Af Ablation ◽  
Life Threatening

Background: Catheter ablation is an increasingly used treatment for symptomatic atrial fibrillation (AF). However, there are limited prospective, nationwide data on patient selection and procedural characteristics. This study describes patient characteristics, techniques, treatment patterns, and safety outcomes of patients undergoing AF ablation. Methods: A total of 3139 patients undergoing AF ablation between 2016 and 2018 in the Get With The Guidelines-Atrial Fibrillation registry from 24 US centers were included. Patient demographics, medical history, procedural details, and complications were abstracted. Differences between paroxysmal and patients with persistent AF were compared using Pearson χ 2 and Wilcoxon rank-sum tests. Results: Patients undergoing AF ablation were predominantly male (63.9%) and White (93.2%) with a median age of 65. Hypertension was the most common comorbidity (67.6%), and patients with persistent AF had more comorbidities than patients with paroxysmal AF. Drug refractory, paroxysmal AF was the most common ablation indication (class I, 53.6%) followed by drug refractory, persistent AF (class I, 41.8%). Radiofrequency ablation with contact force sensing was the most common ablation modality (70.5%); 23.7% of patients underwent cryoballoon ablation. Pulmonary vein isolation was performed in 94.6% of de novo ablations; the most common adjunctive lesions included left atrial roof or posterior/inferior lines, and cavotricuspid isthmus ablation. Complications were uncommon (5.1%) and were life-threatening in 0.7% of cases. Conclusions: More than 98% of AF ablations among participating sites are performed for class I or class IIA indications. Contact force-guided radiofrequency ablation is the dominant technique and pulmonary vein isolation the principal lesion set. In-hospital complications are uncommon and rarely life-threatening.

scholarly journals Short tip–more function? Atrial fibrillation ablation using the novel third-generation cryoballoon in resected pulmonary vein

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Shaojie Chen ◽  
Boris Schmidt ◽  
Stefano Bordignon ◽  
Fabrizio Bologna ◽  
K. R. Julian Chun
Keyword(s):  
Atrial Fibrillation ◽  
Real Time ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Pulmonary Veins ◽  
Cryoballoon Ablation ◽  
Third Generation ◽  
The Novel ◽  
Case Presentation ◽  
Pulmonary Surgery

Abstract Background Cryoballoon ablation is an established procedure for atrial fibrillation (AF). Patients who had previous pulmonary surgery undergoing pulmonary vein isolation (PVI) were seldom reported. Case presentation We describe an AF ablation using the novel short-tip third-generation cryoballoon in a patient with resected pulmonary vein. All pulmonary veins were successfully isolated without complication. The short-tip third-generation cryoballoon shows advantageous profile in PVI for AF patients with previous pulmonary surgery. Conclusions This report indicates that for AF patient who had previous resected PV surgery, the short-tip CB 3 provides an ideal device option for real-time PVI.

New therapy for atrial fibrillation: pulmonary vein isolation by cryoballoon ablation

2008 ◽  
Vol 149 (38) ◽  
pp. 1779-1784 ◽  
Author(s):  
Csaba Földesi ◽  
Attila Kardos ◽  
Attila Mihálcz ◽  
Zoltán Som ◽  
Gabriella Hódi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Cryoballoon Ablation ◽  
New Therapy

A pitvarfibrilláció a leggyakoribb tartós szívritmuszavar, amelynek prevalenciája az utóbbi évtizedekben egyre nőtt és így népegészségügyi problémává vált. Az antiaritmiásgyógyszer-választék bővülése ellenére a pitvarfibrilláció farmakoterápiájának továbbra is jelentős korlátai vannak. Mindezek miatt egyre nagyobb hangsúlyt kaptak a nem gyógyszeres megszüntetést és ritmusmegőrzést célzó technikai fejlesztések, köztük a legnagyobb fejlődést és perspektívát mutató transzkatéteres ablatiós technikák, amelyekhez energiaforrásként jellemzően rádiófrekvenciás energiát használunk. Az ablatiós technikától és a nem elhanyagolható interperszonális különbségektől függően (mind az operatőr, mind a beteg oldaláról) a rádiófrekvenciás ablatio alkalmazása esetén olyan, potenciálisan életveszélyes szövődményektől is kell tartani, mint a tüdővénák stenosisa, illetve atriooesophagealis fisztula kialakulása. A cryoablatio a transzkatéteres ablatio olyan speciális formája, amely nem égetéssel, hanem fagyasztással szünteti meg az aritmiaszubsztrátot. A cryoballonos ablatio során a tüdővénákat átmenetileg ballonnal okkludáljuk, majd a vénaszájadék körkörös fagyasztása révén érhető el a tüdővéna komplett izolációja, amely a paroxizmális pitvarfibrilláció ablatiós kezelésének sarokköve. A cryoballonos ablatióval a rádiófrekvenciás ablatióval megegyező tartós aritmiamentesség érhető el megnövekedett biztonságosság mellett. Intézetünkben hazánkban elsőként végeztünk cryoballonos ablatiót paroxizmális pitvarfibrillációban szenvedő betegeken. Az ennek kapcsán közölt jelen összefoglalóval szeretnénk felhívni a figyelmet e módszer előnyeire, amely viszonylagos egyszerűségével lehetővé teheti, hogy a jövőben e beavatkozás gyorsan és széles körben elterjedjen.

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