scholarly journals Left atrial appendage isolation in addition to pulmonary vein isolation in persistent atrial fibrillation: one-year clinical outcome after cryoballoon-based ablation

EP Europace ◽  
2017 ◽  
Vol 19 (5) ◽  
pp. 758-768 ◽  
Author(s):  
Hikmet Yorgun ◽  
Uğur Canpolat ◽  
Duygu Kocyigit ◽  
Cem Çöteli ◽  
Banu Evranos ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Outcome ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Persistent Atrial Fibrillation ◽  
Atrial Appendage ◽  
One Year ◽  
Left Atrial Appendage Isolation

Long-term outcomes of cryoballoon-based left atrial appendage isolation in addition to pulmonary vein isolation in persistent atrial fibrillation

EP Europace ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. 1653-1662 ◽  
Author(s):  
Hikmet Yorgun ◽  
Uğur Canpolat ◽  
Metin Okşul ◽  
Yusuf Ziya Şener ◽  
Ahmet Hakan Ateş ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Persistent Atrial Fibrillation ◽  
Atrial Appendage ◽  
Left Atrial Appendage Isolation

Abstract Aims Pulmonary vein isolation (PVI) alone in persistent atrial fibrillation (AF) is not as successful as in paroxysmal AF, and recent data indicate the key role of non-PV triggers. We aimed to assess the long-term safety and efficacy of left atrial appendage isolation (LAAi) as an adjunct to PVI using cryoballoon (CB) in persistent AF. Methods and results We compared 144 persistent AF patients (59 ± 10 years, 51% females) who underwent PVI combined with LAAi with a propensity-score matched cohort of 138 persistent AF patients (59 ± 6 years, 52% female) in whom PVI-only was performed. Baseline and follow-up data including electrocardiography (ECG), 24-h Holter ECG’s, and echocardiography were recorded for all patients. Atrial tachyarrhythmia (ATa) recurrence was defined as detection of AF, atrial flutter, or atrial tachycardia (≥30 s) after a 3-month blanking period. At a mean of 30.5 ± 5.6 months follow-up, 85 (61.6%) patients in the PVI-only group and 109 (75.7%) patients in the PVI+LAAi group were free of ATa after the index procedure (P = 0.008). Ischaemic stroke/transient ischaemic attack was detected in 4 (2.9%) patients in PVI-only group and in 5 (3.5%) patients in the PVI+LAAi group (P = 0.784). Cox regression analysis revealed that the PVI-only strategy was found as a significant predictor for recurrence (hazard ratio 3.01, 95% confidence interval 1.81–5.03; P < 0.001). Conclusions Our findings indicated that CB-based LAAi+PVI was associated with a favourable efficacy compared to PVI-only strategy in patients with persistent AF. Although ischaemic event rates were similar between the groups, rigorous adherence to anticoagulation regime is paramount in order to prevent thrombo-embolic complications.

scholarly journals Successful Ablation of Roof Dependent Left Atrial Tachycardia Using Cryoballoon After Pulmonary Vein Isolation.

2020 ◽  
Author(s):  
Kudret Aytemir ◽  
Burak Sezenoz ◽  
Ugur Canpolat ◽  
Hikmet Yorgun
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Left Atrial ◽  
Atrial Tachycardia ◽  
Left Atrial Appendage ◽  
Posterior Wall ◽  
Atrial Appendage ◽  
Established Method ◽  
Left Atrial Appendage Isolation

Cryoballoon technology is a well-established method to provide pulmonary vein isolation in the treatment of atrial fibrillation. Additional lesions such as roof line, posterior wall isolation or left atrial appendage isolation also possible with the same technique. We report a case with roof dependent atrial tachycardia successully terminated by using cryoballoon following pulmonary vein isolation.

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