Second‐generation cryoballoon ablation for recurrent atrial fibrillation after an index procedure with radiofrequency versus cryo: Different pulmonary vein reconnection patterns but similar long‐term outcome—Results of a multicenter analysis

2019 ◽  
Author(s):  
Andrzej Glowniak ◽  
Adam Tarkowski ◽  
Piotr Fic ◽  
Katarzyna Wojewoda ◽  
Jaroslaw Wojcik ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Cryoballoon Ablation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Index Procedure ◽  
Recurrent Atrial Fibrillation ◽  
Multicenter Analysis ◽  
Pulmonary Vein Reconnection

Impact of Pulmonary Vein Anatomy on Long-term Outcome of Cryoballoon Ablation for Atrial Fibrillation

2018 ◽  
Vol 38 (2) ◽  
pp. 259-267 ◽  
Author(s):  
Shang-wei Huang ◽  
Qi Jin ◽  
Ning Zhang ◽  
Tian-you Ling ◽  
Wen-qi Pan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Cryoballoon Ablation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Pulmonary Vein Anatomy

scholarly journals Reconnection Rate and Long-Term Outcome with Adenosine Provocation During Cryoballoon Ablation for Pulmonary Vein Isolation

2017 ◽  
Vol 9 (5) ◽  
Author(s):  
Rachel M Kaplan ◽  
Sanjay Dandamudi ◽  
Martha Bohn ◽  
Nishant Verma ◽  
Todd T Tomson ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Cryoballoon Ablation ◽  
Reconnection Rate ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: Treatment Strategy, Characteristics of Consecutive Atrial Tachycardia and Long‐Term Outcome

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Leon Dinshaw ◽  
Paula Münkler ◽  
Benjamin Schäffer ◽  
Niklas Klatt ◽  
Christiane Jungen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Drug Therapy ◽  
Hypertrophic Cardiomyopathy ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Antiarrhythmic Drug Therapy ◽  
Af Ablation

Background Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HCM) and is associated with a deterioration of clinical status. Ablation of symptomatic AF is an established therapy, but in HCM, the characteristics of recurrent atrial arrhythmias and the long‐term outcome are uncertain. Methods and Results Sixty‐five patients with HCM (aged 64.5±9.9 years, 42 [64.6%] men) underwent AF ablation. The ablation strategy included pulmonary vein isolation in all patients and ablation of complex fractionated atrial electrograms or subsequent atrial tachycardias (AT) if appropriate. Paroxysmal, persistent AF, and a primary AT was present in 13 (20.0%), 51 (78.5%), and 1 (1.5%) patients, respectively. Twenty‐five (38.4%) patients developed AT with a total number of 54 ATs. Stable AT was observed in 15 (23.1%) and unstable AT in 10 (15.3%) patients. The mechanism was characterized as a macroreentry in 37 (68.5%), as a localized reentry in 12 (22.2%), a focal mechanism in 1 (1.9%), and not classified in 4 (7.4%) ATs. After 1.9±1.2 ablation procedures and a follow‐up of 48.1±32.5 months, freedom of AF/AT recurrences was demonstrated in 60.0% of patients. No recurrences occurred in 84.6% and 52.9% of patients with paroxysmal and persistent AF, respectively ( P <0.01). Antiarrhythmic drug therapy was maintained in 24 (36.9%) patients. Conclusions AF ablation in patients with HCM is effective for long‐term rhythm control, and especially patients with paroxysmal AF undergoing pulmonary vein isolation have a good clinical outcome. ATs after AF ablation are frequently observed in HCM. Freedom of atrial arrhythmia is achieved by persistent AF ablation in a reasonable number of patients even though the use of antiarrhythmic drug therapy remains high.

scholarly journals Long-term outcome of paroxysmal atrial fibrillation catheter ablation with and without pulmonary vein dormant conduction after adenosine challenge

2020 ◽  
Vol 164 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Tomas Skala ◽  
Jan Precek ◽  
Martin Hutyra ◽  
Ondrej Moravec ◽  
Zbynek Tudos ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Paroxysmal Atrial Fibrillation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Dormant Conduction

P4764Relationship of the duration of pulmonary vein isolation-refractory non-paroxysmal atrial fibrillation to the middle- to long-term outcome of the ExTRa Mapping-guided ablation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Okuyama ◽  
T Ashihara ◽  
T Ozawa ◽  
Y Fujii ◽  
K Kato ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Real Time ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
High Density ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Mapping System ◽  
Phase Mapping

Abstract Introduction It is reported that for patients with non-paroxysmal (persistent or long-standing persistent) atrial fibrillation (Non-PAF), extended ablation to atrial walls in addition to pulmonary vein isolation (PVI) did not improve the long-term outcome. On the other hand, modulation of Non-PAF drivers (or perpetuators) has been proposed as one of the alternative effective ablation strategies for Non-PAF. Purpose To clarify whether the rotor ablation under online real-time high-density phase mapping system is effective for PVI-refractory Non-PAF ablation. Methods Under such circumstances, our academic group had recently developed the online real-time high-density phase mapping system (ExTRa Mapping™) by industrial alliance. The phase map moving images were based on 41 intra-atrial bipolar signals recorded by a 20-pole spiral-shaped catheter (2.5 cm in diameter) and on in silicorapid prediction of spatio-temporal atrial excitations (artificial intelligence system). Then we applied the ExTRa Mapping to clinical practice in order to directly visualize rotors in patients with Non-PAF, and investigated the middle- to long-term outcome of the ExTRa Mapping-guided rotor ablation (ExTRa-ABL). Results Thirty-eight patients (63±8 y/o, 30 males) with Non-PAF demonstrating refractoriness to PVI were enrolled in this study. Ablation for cavo-tricuspid isthmus and/or superior vena cava isolation was additionally performed at physicians' discretion. After these procedures, the ExTRa-ABL was performed in order to modify Non-PAF substrates, causing rotor control. The modification of the rotors was evaluated by re-mapping with the use of the ExTRa Mapping at the end of each ablation session. Patients were followed at 1, 3, 6 months and every year after the procedure. All of them were followed for 21±8 months. During the follow-up period, Non-PAF was recurred in only 8 of 38 (21%). Furthermore, we found if PVI-refractory Non-PAF duration was shorter than 6 years, the non-recurrence rate remained ≥80% (see Figure), which was markedly better outcome comparing with previous reports with regard to Non-PAF ablation. Figure 1 Conclusion Comparing with conventional Non-PAF ablation strategies, our novel approach with the use of the online real-time high-density phase mapping system might improve medium- to long-term outcome of PVI-refractory Non-PAF treatment.

Pulmonary vein isolation: The impact of pulmonary venous anatomy on long-term outcome of catheter ablation for paroxysmal atrial fibrillation

Heart Rhythm ◽  
2014 ◽  
Vol 11 (4) ◽  
pp. 549-556 ◽  
Author(s):  
Alex J.A. McLellan ◽  
Liang-han Ling ◽  
Diego Ruggiero ◽  
Michael C.G. Wong ◽  
Tomos E. Walters ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Paroxysmal Atrial Fibrillation ◽  
Venous Anatomy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Impact
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