B-PO02-073 ONE-YEAR FOLLOW-UP AFTER WIDE-AREA PULMONARY VEIN ISOLATION USING THE VISUALLY GUIDED LASER BALLOON FOR ATRIAL FIBRILLATION

Abstract Funding Acknowledgements Karolina Weinmann was supported by the Hertha-Nathorff fellowship from Ulm University Background - Obesity is a known risk factor for the incidence and persistence of atrial fibrillation. Many interventional studies proved losing weight correlates with less atrial fibrillation (AF) burden. Purpose – We investigated the influence of overweight and obesity on baseline characteristics, procedural values and outcome after cryoballoon pulmonary vein isolation (cryoballoon PVI). Methods – We investigated 575 patients undergoing cryoballoon PVI at our Medical Center. 142 patients were classified as normal with a body mass index (BMI) of 18.5 – 24.9 kg/m², 239 patients presented overweight with a BMI of 25.0 – 29.9 kg/m² and 194 patients were obese with a BMI over 30.0. We compared the baseline characteristics, the procedural and outcome data of these patients. Results – Comparing baseline characteristics of overweight and obese patients to normal weight patients, obese show the highest portion in hypertension (obese vs. normal: 86.1% vs. 68.3%, p < 0.001), diabetes (26.8% vs. 14.8%, p < 0.05), OSAS (17.0% vs. 2.1%, p < 0.001) and left atrial (LA) diameter (44.6 ± 10.8mm vs. 41.3 ± 12.7mm, p < 0.05). Comparison of procedure duration, fluoroscopy time and area dose product (Gy*cm²), only the area dose product shows a significantly higher value in the overweight and obese patients (p < 0.001). Moreover, comparing the duration of ablation, time to isolation per pulmonary vein between the three groups, the overweight and obese patients show a significantly longer duration of ablation at the RSPV and the time to isolation is significantly higher at the LSPV. Mean follow-up period in our cohort is 517.3 ± 461.3 days (1.4 ± 1.3 years). Kaplan-Meier estimation shows no significant difference between freedom from AT/AF recurrence comparing normal weight, overweight and obese patients (Log-rank p = 0.6). After one year follow-up, 70% of normal weight patients show freedom from atrial arrhythmia recurrence and 69% of overweight patients. Obese patients have a fraction of 75% of freedom from AT/AF recurrence after one year. Comparing the two years follow-up values 56% of the normal BMI patients, 54% of the overweight patients and 62% of obese patients are free from arrhythmia recurrence. Conclusion – Cryoballoon PVI procedure in obese and overweight patients is a feasible treatment, however the radiation exposure is higher compared to normal weight. Evaluating outcomes, no difference in recurrence of AF was detected between normal, overweight and obese patients after cryoballoon PVI.

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Five-year clinical outcomes of visually guided laser balloon pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation

Clinical Research in Cardiology ◽

10.1007/s00392-017-1199-6 ◽

2017 ◽

Vol 107 (5) ◽

pp. 405-412 ◽

Cited By ~ 15

Author(s):

Bruno Reissmann ◽

Thorsten Budelmann ◽

Erik Wissner ◽

Michael Schlüter ◽

Christian-Hendrik Heeger ◽

...

Keyword(s):

Atrial Fibrillation ◽

Clinical Outcomes ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Paroxysmal Atrial Fibrillation ◽

Visually Guided ◽

Laser Balloon

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One-year follow-up after pulmonary vein isolation using a single mesh catheter in patients with paroxysmal atrial fibrillation

Heart Rhythm ◽

10.1016/j.hrthm.2009.11.013 ◽

2010 ◽

Vol 7 (3) ◽

pp. 333-339 ◽

Cited By ~ 13

Author(s):

Clemens Steinwender ◽

Simon Hönig ◽

Franz Leisch ◽

Robert Hofmann

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Paroxysmal Atrial Fibrillation ◽

Mesh Catheter ◽

One Year

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Is There an Association between Epicardial Adipose Tissue and Outcomes after Paroxystic Atrial Fibrillation Catheter Ablation?

Journal of Clinical Medicine ◽

10.3390/jcm10143037 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3037

Author(s):

Néfissa Hammache ◽

Hugo Pegorer-Sfes ◽

Karim Benali ◽

Isabelle Magnin Poull ◽

Arnaud Olivier ◽

...

Keyword(s):

Atrial Fibrillation ◽

Adipose Tissue ◽

Catheter Ablation ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Epicardial Adipose Tissue ◽

University Hospital ◽

One Year ◽

Af Recurrence

Background: In patients undergoing paroxysmal atrial fibrillation (PAF) ablation, pulmonary vein isolation (PVI) alone fails in maintaining sinus rhythm in up to one third of patients after a first catheter ablation. Epicardial adipose tissue (EAT), as an endocrine-active organ, could play a role in the recurrence of AF after catheter ablation. Objective: To evaluate the predictive value of clinical, echocardiographic, biological parameters and epicardial fat density measured by computed tomography scan (CT-scan) on AF recurrence in PAF patients who underwent a first pulmonary vein isolation procedure using radiofrequency (RF). Methods: This monocentric retrospective study included all patients undergoing first-time RF PAF ablation at the Nancy University Hospital between March 2015 and December 2018 with one-year follow-up. Results: 389 patients were included, of whom 128 (32.9%) had AF recurrence at one-year follow-up. Neither total-EAT volume (88.6 ± 37.2 cm3 vs. 91.4 ± 40.5 cm3, p = 0.519), nor total-EAT radiodensity (−98.8 ± 4.1 HU vs. −98.8 ± 3.8 HU, p = 0.892) and left atrium-EAT radiodensity (−93.7 ± 4.3 HU vs. −93.4 ± 6.0 HU, p = 0.556) were significantly associated with AF recurrence after PAF ablation. In multivariate analysis, previous cavo-tricuspid isthmus (CTI) ablation, ablation procedure duration, BNP and triglyceride levels remained independently associated with AF recurrence after catheter ablation at 12-months follow-up. Conclusion: Contrary to persistent AF, EAT parameters are not associated with AF recurrence after paroxysmal AF ablation. Thus, the role of the metabolic atrial substrate in PAF pathophysiology appears less obvious than in persistent AF.

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B-PO01-045 A PROSPECTIVE MULTICENTER U.S. COMPARISON OF RADIOFREQUENCY, CRYOBALLOON, AND LASER BALLOON MODALITIES FOR PULMONARY VEIN ISOLATION ABLATION IN PATIENTS WITH ATRIAL FIBRILLATION

Heart Rhythm ◽

10.1016/j.hrthm.2021.06.191 ◽

2021 ◽

Vol 18 (8) ◽

pp. S69

Author(s):

Henry D. Huang ◽

Carlos Macias ◽

Jeanne M. Du-Fay-de-Lavallaz ◽

Rodriguez M. Jason ◽

Sophia Kenigsberg ◽

...

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Laser Balloon

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Up to 6-year follow-up after pulmonary vein isolation for persistent/permanent atrial fibrillation: Importance of sinus node function

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2010.04.045 ◽

2011 ◽

Vol 141 (6) ◽

pp. 1455-1460 ◽

Cited By ~ 3

Author(s):

Yoshiharu Soga ◽

Hitoshi Okabayashi ◽

Yoshio Arai ◽

Takuya Nomoto ◽

Jota Nakano ◽

...

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Sinus Node ◽

Permanent Atrial Fibrillation

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Cryoballoon Atrial Fibrillation Ablation in a Patient with an Atrial Septal Defect Closure Device

The Journal of Tehran University Heart Center ◽

10.18502/jthc.v16i1.6602 ◽

2021 ◽

Author(s):

Meisam Mokhtari ◽

Zahra Khajali ◽

Mona Heidarali ◽

Majid Haghjoo

Keyword(s):

Atrial Fibrillation ◽

Atrial Septal Defect ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Septal Defect ◽

Closure Device ◽

Atrial Septal Defect Closure ◽

Occluder Device ◽

Asd Closure

Atrial fibrillation (AF) is the most commonly treated arrhythmia in clinical practice and is often found in association with an atrial septal defect (ASD). However, ASD closure rarely confers complete arrhythmia control. A 23-year-old man presented to our center with frequent episodes of palpitations. AF was documented in 12-lead electrocardiography, and echocardiography showed a secundum-type ASD, 14 mm in size, with a significant left-to-right shunt. ASD closure was performed successfully with an ASD occluder device with no residual shunting. During follow-up, the patient experienced several episodes of AF. Thirteen months after the ASD closure, cryoballoon pulmonary vein isolation was done successfully with no complications. During a 12-month follow-up, he had no symptoms or AF recurrences, and echocardiography showed no residual shunting. This study showed that cryoballoon pulmonary vein isolation could be performed successfully without residual shunts in patients with ASD closure devices.

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