scholarly journals Near zero fluoroscopy cryoballoon catheter ablation in patients with atrial fibrillation using a novel dielectric imaging system

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Schillaci ◽  
G Stabile ◽  
A Arestia ◽  
G Shopova ◽  
A Agresta ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Imaging System ◽  
Cryoballoon Ablation ◽  
The Novel ◽  
System P ◽  
Fluoroscopy Guidance ◽  
New System ◽  
Mapping Catheter ◽  
Zero Fluoroscopy

Abstract Background Fluoroscopy is commonly used in cryoballoon catheter ablation for pulmonary vein (PV) isolation procedures in patients with atrial fibrillation (AF). Purpose The purpose of this study was to verify the feasibility of a new dielectric imaging system in reducing the radiation exposure during cryoballoon ablation in patients with AF. Methods We enrolled 40 consecutive patients with paroxysmal AF: 20 patients underwent the procedure under fluoroscopy guidance before the new system introduction, while 20 patient underwent the procedure under fluoroscopy and a new dielectric imaging system guidance with its occlusion tool software. After transseptal access a detailed image reconstruction of left atrium and PVs was achieved with an octapolar circular mapping catheter and the cryoablation was performed with a cryoballoon catheter. Results Total time of the procedure was comparable between the two groups (90.15±28.67 vs 80.77±17.17 using the dielectric imaging system, p=0.34), while fluoroscopy time was significantly lower in the group using the new dielectric imaging system (16.92±8.96 vs 5.54±2.06, p<0.01). Acute isolation was achieved in all PVs. No 30 days complication was observed. Conclusion This is the first study that demonstrates the feasibility of a reduce fluoroscopy workflow using the novel dielectric imaging system in a cryoballoon procedure. Funding Acknowledgement Type of funding source: None

scholarly journals Near zero fluoroscopy in cryoballoon catheter ablation in patients with atrial fibrillation using the new KODEX-EPD imaging system

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
V Schillaci ◽  
G Stabile ◽  
A Arestia ◽  
G Shopova ◽  
F Solimene
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Imaging System ◽  
The Arctic ◽  
Fluoroscopy Time ◽  
Cryoballoon Ablation ◽  
The Novel ◽  
Funding Sources ◽  
Front Advance ◽  
Mapping Catheter

Abstract Funding Acknowledgements Type of funding sources: None. Background. Fluoroscopy is commonly used in cryoballoon catheter ablation for pulmonary vein (PV) isolation procedures in patients with atrial fibrillation (AF). Objective The purpose of this study was to verify the feasibility of a new dielectric imaging system in reducing the radiation exposure during cryoballoon ablation in patients with AF. Methods We enrolled 26 consecutive patients with paroxysmal AF: 13 patients underwent the procedure under fluoroscopy guidance before the new system introduction, while 13 patient underwent the procedure under fluoroscopy and KODEX-EPD system guidance with its occlusion tool software. After transseptal access a detailed image reconstruction of left atrium and PVs was achieved with the Achieve octapolar circular mapping catheter and the cryoablation was performed with the Arctic Front Advance cryoballoon. Results Total time of the procedure was comparable between the two groups (90.15 ± 28.67 vs 80.77 ± 17.17 using KODEX-EPD, p = 0.34), while fluoroscopy time was significantly lower in the group using KODEX-EPD (16.92 ± 8.96 vs 5.54 ± 2.06, p < 0.01). Acute isolation was achieved in all PVs. No 30 days complication was observed. Conclusion This is the first study that demonstrates the feasibility of a reduce fluoroscopy workflow using the novel KODEX-EPD system in a cryoballoon procedure. Abstract Figure. Fluoroscopy time

Novel occlusion tool software for pulmonary vein occlusion verification in atrial fibrillation cryoballoon ablation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Solimene ◽  
F.M Cauti ◽  
G Stabile ◽  
P Rossi ◽  
V Schillaci ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Predictive Value ◽  
Imaging System ◽  
Cryoballoon Ablation ◽  
The Novel ◽  
Contrast Injection ◽  
Sensing System ◽  
Vein Occlusion ◽  
Mapping Catheter

Abstract Background Optimal pulmonary vein (PV) occlusion, checked with selective contrast injection, is mandatory to obtain an effective PV isolation with a cryoballoon. Purpose The purpose of this study was to verify the feasibility of a new dielectric sensing system in assessing PV occlusion during cryoballoon ablation in patients with atrial fibrillation (AF). Methods We enrolled 25 consecutive patients with paroxysmal or persistent AF. After transseptal access a detailed image reconstruction of left atrium and PVs was achieved with a decapolar circular mapping catheter and a novel dielectric imaging system. The degree of PV occlusion with the inflated cryoballoon catheter was verified by a new occlusion tool software of the dielectric imaging system and compared to the angiography with dye injection in each PV. Results A total of 114 PV cryoballoon occlusion were tested. The new occlusion tool software showed a 91.7% sensitivity and 81.5% specificity in assessing a complete PV occlusion verified with dye injection. The positive predictive value was 84.6% and the negative predictive value was 89.8%. Acute isolation was achieved in all PVs. No 30 days complications were observed. Conclusion This is the first study that demonstrates the feasibility of a new occlusion tool software, using the novel dielectric imaging system, in verifying the degree of PV occlusion during cryoballoon ablation. Funding Acknowledgement Type of funding source: None

scholarly journals Zero fluoroscopy cryballoon catheter ablation of paroxysmal atrial fibrillation

2021 ◽  
Vol 27 (4) ◽  
pp. 12-16
Author(s):  
E. B. Kropotkin ◽  
E. A. Ivanitskiy ◽  
D. A. Shlyakov ◽  
Yu. V. Ivanitskaya ◽  
V. A. Sakovich
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Cryoballoon Ablation ◽  
Drug Resistant ◽  
Safety And Efficacy ◽  
Zero Fluoroscopy

To assess safety and efficacy of nonfluoroscopic cryoballoon ablation, 32 patients with symptomatic drug resistant paroxysmal atrial fibrillation were treated.

Fluoroscopy and contrast media use in cryoballoon ablation of atrial fibrillation using a novel imaging system

2021 ◽  
Author(s):  
Vincenzo Schillaci ◽  
Giuseppe Stabile ◽  
Alberto Arestia ◽  
Gergana Shopova ◽  
Alessia Agresta ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Contrast Media ◽  
Imaging System ◽  
Media Use ◽  
Cryoballoon Ablation

scholarly journals Outcome of contact force-guided radiofrequency catheter ablation or second generation cryoballoon ablation for paroxysmal atrial fibrillation: propensity score matched analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Ukita ◽  
A Kawamura ◽  
H Nakamura ◽  
K Yasumoto ◽  
M Tsuda ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Propensity Score ◽  
Contact Force ◽  
Paroxysmal Atrial Fibrillation ◽  
Radiofrequency Catheter Ablation ◽  
Second Generation ◽  
Late Recurrence ◽  
Cryoballoon Ablation ◽  
Atrial Tachyarrhythmia

Abstract Background Little has been reported on the outcome of contact force (CF)-guided radiofrequency catheter ablation (RFCA) and second generation cryoballoon ablation (CBA). Purpose The purpose of this study was to compare the outcome of CF-guided RFCA and second generation CBA for paroxysmal atrial fibrillation (PAF). Methods We enrolled the consecutive 364 patients with PAF who underwent initial ablation between September 2014 and July 2018 in our hospital. We compared the late recurrence of atrial tachyarrhythmia more than three months after ablation between RFCA group and CBA group. All RFCA procedures were performed using CF-sensing catheter and all CBA procedures were performed using second generation CB. Results There were significant differences in background characteristics: chronic kidney disease, serum brain natriuretic peptide level, and left ventricular ejection fraction. After propensity score matched analysis (Table), atrial tachyarrhythmia free survival was significantly higher in CBA group than in RFCA group (Figure). Conclusions Second generation CBA showed a significantly lower late recurrence rate compared to CF-guided RFCA. Kaplan-Meier Curve Funding Acknowledgement Type of funding source: None

Abstract 16237: Zero Fluoroscopy Ablation of Atrial Fibrillation: A Safety and Feasibility Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Luigi Di Biase ◽  
Rodney Horton ◽  
Chintan Trivedi ◽  
Prasant Mohanty ◽  
Sanghamitra Mohanty ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Veins ◽  
Radiation Risk ◽  
Control Group ◽  
Short Term ◽  
Af Ablation ◽  
And Control ◽  
Zero Fluoroscopy

Introduction: Radiofrequency catheter ablation of atrial fibrillation is performed under fluoroscopic guidance and therefore carries radiation risk exposure for the both the patient and the operator. Three-dimensional mapping systems and newer technologies to allow non-fluoroscopic catheter visualization together with intracardiac echo have reduced but not abolished the fluoroscopy exposure. We aim to demonstrate the feasibility, the safety and the efficacy of catheter ablation for atrial fibrillation without the use of fluoroscopy. Methods: A totally fluoro-less approach was developed for AF ablation at our Institution. 94 consecutive AF patients underwent zero fluoroscopy catheter ablation for atrial fibrillation. In the zero fluoroscopy cases, the fluoroscopy arm was kept far away from the patient table. Access including double trans-septal, mapping with the Carto 3 system and ablation were all performed without fluoroscopy with the use of ICE and the Carto 3 system. These 94 patients were compared with 94 control patients matched for age, sex and type of AF who underwent AF ablation by the same operator with the use of fluoroscopy. Results: Baseline characteristics were similar between fluoroless (N=94, Age=64.5 ± 10.1, 75.5% male, 48% paroxysmal) and control (N=94, Age=65.1 ± 9.9, 72.3% male, 50% paroxysmal) group. Non-PV triggers were detected and ablated in 51 (54.3%) and 56 (59.6%) patients in fluoroless and control group respectively (p=0.5). Average fluoro time in control group was 10.1 ± 4.7 minutes. Procedure duration was comparable (120.4 ± 25.8 vs. 122.2 ± 28.7, p =0.6). After the short term median follow-up of 4.5 (4 – 6.5) months, 10 (10.6 %) patients in flourless and 9 (9.6%) patients in control group experienced recurrences (p=0.8).One pericardial effusion requiring pericardiocenteis occurred in the fluoroless group. Conclusions: Our series show that zero fluoroscopy ablation of atrial fibrillation with the use of newer technologies is feasible, safe and efficacious at the short term follow up. Importantly in our series the double transeptal was performed without fluoroscopy and the ablation was not limited to the pulmonary veins only but included ablation of the posterior wall, the coronary sinus and the left atrial appendage.

scholarly journals P308Never underestimate the power of the force: lessions from catheter ablation of atrial fibrillation using the novel thermocool smarttouch surround flow ablation catheter

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii49-iii49
Author(s):  
C. Sohns ◽  
T. Maurer ◽  
L. Rottner ◽  
CH. Heeger ◽  
T. Fink ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
The Novel ◽  
Ablation Catheter
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