scholarly journals Accuracy comparison of the new and previous kodex occlusion tool software versions to assess pulmonary vein occlusion in atrial fibrillation cryoablation

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
FM Cauti ◽  
P Rossi ◽  
L Iaia ◽  
M Polselli ◽  
A Pecere ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Positive Predictive Value ◽  
Contrast Medium ◽  
Negative Predictive Value ◽  
Pulmonary Vein ◽  
Predictive Value ◽  
First Generation ◽  
Second Generation ◽  
Cryoballoon Ablation ◽  
Contrast Medium Injection

Abstract Funding Acknowledgements Type of funding sources: None. Background. Atrial fibrillation (AF) is the most frequent sustained arrhythmia worldwide and Cryoballoon ablation (CB) has become a consolidated alternative to the radiofrequency pulmonary vein (PV) isolation. However, CB requires fluoroscopy and dye injections to verify the occlusion grade. The accuracy of the earlier version of the Kodex Occlusion Tool software has been studied. Purpose. The purpose of this study was to verify the accuracy of the second generation Kodex Occlusion Tool Software of a new dielectric system imaging compared to its first generation to detect PV occlusion during CB ablation in patients with AF. Methods. 15 consecutive patients with paroxysmal AF were enrolled in the study and underwent the procedure with the guidance of the first generation version (1.4.6) of the Kodex Occlusion Tool software. The Kodex recorded procedural data were used to replay the case using the Kodex second generation version (1.4.7) of the Occlusion Tool software when clinically available. After transseptal access, a detailed image reconstruction of left atrium and PVs was achieved with an octa-polar circular mapping catheter, PV occlusion was assessed with the Occlusion Tool Software and compared with standard dye injection and angiography, the cryoablation was then performed with a cryoballoon catheter. Results. A total of 72 PVs CB occlusions were tested. The old version showed 90.7% sensitivity and 76.5% specificity in assessing a complete PV occlusion verified with contrast medium injection. The positive predictive value was 80.3%, and the negative predictive value was 88.6%. The new version showed 94.8% sensitivity and 93.7% specificity in assessing a complete PV occlusion verified with same contrast medium injection data. The positive predictive value was 98.2%, and the negative predictive value was 93.7%. Acute isolation was achieved in all PVs and no 30-day complication was observed. Conclusion. This study demonstrates an increased accuracy of new Occlusion Tool software of the Kodex dielectric imaging system to assess the degree of PV occlusion during a CB ablation. Abstract Figure. Occlusion tool software 1.4.6 vs 1.4.7

scholarly journals Accuracy comparison of the new and previous Kodex occlusion tool software versions to assess pulmonary vein occlusion in atrial fibrillation cryoablation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F M Cauti ◽  
P Rossi ◽  
L Iaia ◽  
M Polselli ◽  
A Pecere ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Positive Predictive Value ◽  
Contrast Medium ◽  
Negative Predictive Value ◽  
Pulmonary Vein ◽  
Predictive Value ◽  
First Generation ◽  
Second Generation ◽  
Cryoballoon Ablation ◽  
Contrast Medium Injection

Abstract Background Atrial fibrillation (AF) is the most frequent sustained arrhythmia worldwide and Cryoballoon ablation (CB) has become a consolidated alternative to the radiofrequency pulmonary vein (PV) isolation. However, CB requires fluoroscopy and dye injections to verify the occlusion grade. The accuracy of the earlier version of the Kodex Occlusion Tool software has been studied. Purpose The purpose of this study was to verify the accuracy of the second generation Kodex Occlusion Tool Software of a new dielectric system imaging compared to its first generation to detect PV occlusion during CB ablation in patients with AF. Methods 15 consecutive patients with paroxysmal AF were enrolled in the study and underwent the procedure with the guidance of the first generation version (1.4.6) of the Kodex Occlusion Tool software. The Kodex recorded procedural data were used to replay the case using the Kodex second generation version (1.4.7) of the Occlusion Tool software when clinically available. After transseptal access, a detailed image reconstruction of left atrium and PVs was achieved with an octa-polar circular mapping catheter, PV occlusion was assessed with the Occlusion Tool Software and compared with standard dye injection and angiography, the cryoablation was then performed with a cryoballoon catheter. Results A total of 74 PVs CB occlusions were tested. The old version showed 90.7% sensitivity and 74.2% specificity in assessing a complete PV occlusion verified with contrast medium injection. The positive predictive value was 82.9%, and the negative predictive value was 85.2%. The new version showed 94.8% sensitivity and 93.7% specificity in assessing a complete PV occlusion verified with same contrast medium injection data. The positive predictive value was 98.2%, and the negative predictive value was 93.7%. Acute isolation was achieved in all PVs and no 30-day complication was observed. Conclusion This study demonstrates an increased accuracy of new Occlusion Tool software of the Kodex dielectric imaging system to assess the degree of PV occlusion during a CB ablation. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Pulmonary vein anatomy addressed by computed tomography and relation to success of second‐generation cryoballoon ablation in paroxysmal atrial fibrillation

2019 ◽  
Vol 42 (4) ◽  
pp. 438-443 ◽  
Author(s):  
Bart A. Mulder ◽  
Meelad I. H. Al‐Jazairi ◽  
Bauke K. O. Arends ◽  
Niels Bax ◽  
Leonard A. Dijkshoorn ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Paroxysmal Atrial Fibrillation ◽  
Second Generation ◽  
Cryoballoon Ablation ◽  
Pulmonary Vein Anatomy

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 Diagnostic Performance of a Smart Device With Photoplethysmography Technology for Atrial Fibrillation Detection: Pilot Study (Pre-mAFA II Registry) (Preprint)

2018 ◽  
Author(s):  
Yong-Yan Fan ◽  
Yan-Guang Li ◽  
Jian Li ◽  
Wen-Kun Cheng ◽  
Zhao-Liang Shan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Positive Predictive Value ◽  
Mobile Phone ◽  
Negative Predictive Value ◽  
Mobile Phones ◽  
Predictive Value ◽  
Normal Sinus Rhythm ◽  
Smart Devices ◽  
Smart Device ◽  
Significant Difference

BACKGROUND Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The asymptomatic nature and paroxysmal frequency of AF lead to suboptimal early detection. A novel technology, photoplethysmography (PPG), has been developed for AF screening. However, there has been limited validation of mobile phone and smart band apps with PPG compared to 12-lead electrocardiograms (ECG). OBJECTIVE We investigated the feasibility and accuracy of a mobile phone and smart band for AF detection using pulse data measured by PPG. METHODS A total of 112 consecutive inpatients were recruited from the Chinese PLA General Hospital from March 15 to April 1, 2018. Participants were simultaneously tested with mobile phones (HUAWEI Mate 9, HUAWEI Honor 7X), smart bands (HUAWEI Band 2), and 12-lead ECG for 3 minutes. RESULTS In all, 108 patients (56 with normal sinus rhythm, 52 with persistent AF) were enrolled in the final analysis after excluding four patients with unclear cardiac rhythms. The corresponding sensitivity and specificity of the smart band PPG were 95.36% (95% CI 92.00%-97.40%) and 99.70% (95% CI 98.08%-99.98%), respectively. The positive predictive value of the smart band PPG was 99.63% (95% CI 97.61%-99.98%), the negative predictive value was 96.24% (95% CI 93.50%-97.90%), and the accuracy was 97.72% (95% CI 96.11%-98.70%). Moreover, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of mobile phones with PPG for AF detection were over 94%. There was no significant difference after further statistical analysis of the results from the different smart devices compared with the gold-standard ECG (P>.99). CONCLUSIONS The algorithm based on mobile phones and smart bands with PPG demonstrated good performance in detecting AF and may represent a convenient tool for AF detection in at-risk individuals, allowing widespread screening of AF in the population. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR-OOC-17014138; http://www.chictr.org.cn/showproj.aspx?proj=24191 (Archived by WebCite at http://www.webcitation/76WXknvE6)

Optimal diameter of the pulmonary vein ostium for second‐generation 28‐mm cryoballoon ablation of atrial fibrillation

2020 ◽  
Vol 43 (2) ◽  
pp. 201-209 ◽  
Author(s):  
Sayaka Kurokawa ◽  
Koichi Nagashima ◽  
Ryuta Watanabe ◽  
Masaru Arai ◽  
Yuji Wakamatsu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Second Generation ◽  
Cryoballoon Ablation ◽  
Pulmonary Vein Ostium ◽  
Optimal Diameter

P6538Validity of two weeks daily self pulse-palpation for opportunistic screening for atrial fibrillation among patients 65 years and older

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Ghazal ◽  
F Al-Khalili ◽  
M Rosenqvist
Keyword(s):  
Atrial Fibrillation ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Single Time ◽  
Measurement Occasion ◽  
Pulse Palpation ◽  
Single Time Point ◽  
Irregular Pulse ◽  
Time Point

Abstract Background Pulse-palpation is recommended (ESC IA) for single time-point screening for atrial fibrillation (AF). AF may, however, be paroxysmal which can make AF detection difficult to detect on single time-point measurement. Intermittent ECG recording is a sensitive method to detect AF. However, the role of pulse-palpation for AF detection has not been validated against simultaneous ECG recordings. Purpose To study the validity of AF detection using self pulse-palpation simultaneously with hand-hold ECG recording 3 times daily for two weeks for AF. Method Patients 65 years and older visiting four primary health care centers, four any reason, were invited to AF screening from July 2017 to December 2018. Hand-held intermittent ECG recordings, 30 seconds three times a day, was offered to participants without AF for a period of 2 weeks. Patients were instructed how to take their own pulse, simultaneously with intermittent ECG measurement and in written to note whether it was irregular or not. Results A total of 1010 patients (mean age 73 years, 61% women) participated in the study, 27 new cases of AF (mostly paroxysmal) were detected. Totally 53 782 simultaneous ECG-recordings and pulse-measurements were registered. AF was verified in 311 ECG-recordings but the pulse was palpated as irregular only in 77 of these recordings (25% sensitivity per measurement-occasion). Of those 27 detected AF cases, 15 cases felt their pulse as irregular at least at once occasion (56% sensitivity per individuals). 187 individuals without AF felt their pulse as irregular in at least one occasion. The specificity per measurement-occasion and per individuals were 98% and 81% respectively. Diagnostic odds ratio was 5.3. AF 27 patients No AF 983 patients Irregular pulse 202 individuals 15 187 Regular pulse 808 individuals 12 796 Sensitivity 56% Specificity 81% Positive Predictive Value 7% Negative Predictive Value 99% AF 311 measurements No AF 53471 measurements Irregular pulse 1046 measurements 77 969 Regular pulse 52,736 measurements 234 52,502 Sensitivity 25% Specificity 98% Positive Predictive Value 7% Negative Predictive Value 99% Conclusion AF screening using own pulse-palpation 3 times daily for two weeks is feasible but has a low sensitivity for AF detection. Acknowledgement/Funding This study was supported by the Swedish Heart and Lung Foundation, Pfizer, Boehringer-Ingelheim and Bayer

Sign in / Sign up

Export Citation Format

Share Document