scholarly journals Two-Dimensional Phased Array Color-Flow Doppler Intracardiac Echo (2D-ICE) in Combination with the 2nd Generation 28 mm Cryoablation Balloon and 20mm Achieve Circular Mapping System (Arctic Front Advance, Medtronic, USA) for Ablation of Atrial Fibrillation: The ICE2 technique (ICE2T): A Retrospective Review of a Community Based Single Center Atrial Fibrillation Ablation Program

2015 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Phased Array ◽  
Two Dimensional ◽  
Single Center ◽  
Community Based ◽  
Color Flow ◽  
2Nd Generation ◽  
Mapping System ◽  
Front Advance ◽  
Arctic Front

scholarly journals Multi-catheter cryotherapy compared with radiofrequency ablation in long-standing persistent atrial fibrillation: a randomized clinical trial

EP Europace ◽  
2020 ◽  
Author(s):  
Mark M Gallagher ◽  
Gang Yi ◽  
Hanney Gonna ◽  
Lisa W M Leung ◽  
Idris Harding ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Persistent Atrial Fibrillation ◽  
Rf Ablation ◽  
Ablation Efficiency ◽  
Mapping System ◽  
3D Mapping System ◽  
Front Advance

Abstract Aims Restoring sinus rhythm (SR) by ablation alone is an endpoint used in radiofrequency (RF) ablation for long-standing persistent atrial fibrillation (AF) but not with cryotherapy. The simultaneous use of two cryotherapy catheters can improve ablation efficiency; we compared this with RF ablation in chronic persistent AF aiming for termination to SR by ablation alone. Methods and results Consecutive patients undergoing their first ablation for persistent AF of >6 months duration were screened. A total of 100 participants were randomized 1:1 to multi-catheter cryotherapy or RF. For cryotherapy, a 28-mm Arctic Front Advance was used in tandem with focal cryoablation catheters. Open-irrigated, non-force sensing catheters were used in the RF group with a 3D mapping system. Pulmonary vein (PV) isolation and non-PV triggers were targeted. Participants were followed up at 6 and 12 months, then yearly. Acute PVI was achieved in all cases. More patients in the multi-catheter cryotherapy group were restored to SR by ablation alone, with a shorter procedure duration. Sinus rhythm continued to the last available follow-up in 16/49 patients (33%) in the multi-catheter at 3.0 ± 1.6 years post-ablation and in 12/50 patients (24%) in the RF group at 4.0 ± 1.2 years post-ablation. The yearly rate of arrhythmia recurrence was similar. Conclusion Multi-catheter cryotherapy can restore SR by ablation alone in more cases and more quickly than RF ablation. Long-term success is difficult to achieve by either methods and is similar with both.

Experience in cryobaloon atrial fibrillation ablation – Polish operators perspective

2019 ◽  
Vol 2 (51) ◽  
pp. 4-7
Author(s):  
Agnieszka Wojdyła-Hordyńska ◽  
Jakub Baran ◽  
Paweł Derejko
Keyword(s):  
Atrial Fibrillation ◽  
Second Generation ◽  
Pulmonary Veins ◽  
Atrial Fibrillation Ablation ◽  
Cryoballoon Ablation ◽  
Years Of Experience ◽  
Technology Changes ◽  
Front Advance ◽  
Arctic Front ◽  
Over 40 Years

The first use of cryoablation in the treatment of arrhythmia has already been described over 40 years ago [1]. Since the introduction of cryoballoon in pulmonary veins isolation in atrial fibrillation treatment, the method has started to attract a lot of interest. Over 350,000 procedures around the word were carried out only by 2018 [2]. Recently, there have been several new publications on the results of second-generation cryoballoon ablation [2, 3, 4]. In view of technology changes, and to summarize years of experience in the treatment of atrial fibrillation, the first Cryousers conference was organized, and held in 2018 in Poland. During this meeting a survey was conducted, obtaining data on the practice of atrial fibrillation treatment in 38 Polish electrophysiological centers performing cryoablation of atrial fibrillation using both balloons, Arctic Front Advance, Medtronic Inc., Minneapolis MN, and radiofrequency point by point ablation. Around 3,745 cryoballoon procedures were performed in the surveyed centers during the year preceding the survey. The survey concerned practical issues related to the qualification and preparation of patients for the procedure, its course, and the results of pulmonary veins isolation in Poland.

scholarly journals Cryoballoon atrial fibrillation ablation: Single-center safety and efficacy data using a novel cryoballoon technology compared to a historical balloon platform.

2020 ◽  
Author(s):  
Adriano Kochi ◽  
Massimo Moltrasio ◽  
Fabrizio Tundo ◽  
Sfefania Isabella Riva ◽  
Ciro Ascione ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Veins ◽  
Similar Efficacy ◽  
The Novel ◽  
Single Center ◽  
Historical Cohort ◽  
Safety And Efficacy ◽  
Procedural Time ◽  
Front Advance ◽  
First Time

Introduction: Catheter ablation is superior to drugs regarding atrial fibrillation (AF) recurrence, symptoms improvement, and mortality reduction in heart failure. POLARx™ is a novel cryoballoon, with technical improvements seeking to improve outcomes. So far, its clinical evidence is restricted to a case report. Methods: To compare the POLARx™ cryoballoon procedural safety and efficacy to the already established Arctic Front Advance PRO™ (AFAP) in a single-center cohort study, consecutive patients undergoing AF cryoablation with the POLARx™ were enrolled. Data were prospectively gathered. POLARx™ patients were compared to a historical cohort of patients submitted to AF cryoablation with the AFAP. Results: Seventy patients were analyzed, 20 in POLARx™, and 50 in the AFAP group. They all underwent first-time pulmonary vein isolation, 77% were male, 94% had paroxysmal AF, median age was 62.5 years, median CHA2DS2-VASc 1, left-atrium size 34ml/m², and 65% were receiving anticoagulation. The primary end-point, all pulmonary veins isolation, was 100% in both groups. The complication rate was similar (0% POLARx™ vs. 5.7% AFAP, p=0.39). The median total procedural time was longer in the POLARx™ group (90min vs. 60min, p<0.001), but the overall time-to-isolation (TTI) (44.8sec vs. 39sec, p=0.253) and ablation time (15min vs. 13.7min, p=0.122) was similar between POLARx™ and AFAP groups, respectively. Despite equal TTI, the POLARx™ had a lower minimal temperature reached (-57ºC vs -47ºC, p<0.001). Conclusion: The novel POLARx™ cryoballoon had similar efficacy and safety compared to the AFAP. It was also associated with longer procedural times, similar TTI, and lower minimum temperature reached.

Ablation of atrial fibrillation using the fourth-generation cryoballoon Arctic Front Advance PRO

2021 ◽  
Vol 17 (1) ◽  
pp. 81-87
Author(s):  
Erik Wissner
Keyword(s):  
Atrial Fibrillation ◽  
Second Generation ◽  
Retrospective Studies ◽  
Pulmonary Veins ◽  
Thermodynamic Characteristics ◽  
The Arctic ◽  
Fourth Generation ◽  
Safety And Efficacy ◽  
Front Advance ◽  
Arctic Front

The cryoballoon (CB) is a popular ablation technology used for pulmonary vein isolation. The fourth-generation CB, Arctic Front Advance PRO features a 40% shorter distal tip but retains the internal design from its second-generation predecessor. The Arctic Front Advance PRO and the second-generation CB demonstrated similar thermodynamic characteristics in a computational model. Several observational and retrospective studies established the acute safety and efficacy of the Arctic Front Advance PRO. Real-time electrical isolation was observed in 75–85% of pulmonary veins targeted with the Arctic Front Advance PRO resulting in shorter fluoroscopy and procedure times.

scholarly journals Feasibility and safety of left atrial posterior wall isolation with a new Cryoballoon technology in patients with persistent atrial fibrillation

2021 ◽  
Author(s):  
Antonio Bisignani ◽  
Luigi Pannone ◽  
Vincenzo Miraglia ◽  
Juan Sieira ◽  
Saverio Iacopino ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Persistent Atrial Fibrillation ◽  
Posterior Wall ◽  
The Arctic ◽  
Cryoballoon Ablation ◽  
The Novel ◽  
Front Advance ◽  
Arctic Front ◽  
Left Atrial Posterior

Introduction: Left atrial posterior wall isolation (LAPWI) is often performed in addition to pulmonary vein isolation (PVI) to improve outcome in patients with persistent atrial fibrillation (AF). In this setting, LAPWI + PVI using cryoballoon ablation had comparable results with radiofrequency ablation (RFA). The aim of the study is to evaluate the feasibility and safety of a new cryoballoon ablation system in PVI + LAPWI isolation, comparing it with the historical platform. Methods: The study was a prospective, non-randomized, single center study. Forty consecutive patients, undergoing PVI + LAPWI with the novel POLARx™, were compared to 40 consecutive patients who underwent the same procedure with the established Arctic Front Advance PRO™. Results: Acute isolation was achieved in all PVs in both groups and LAPWI was achieved in 38 patients (95%) in the POLARx group and in 36 patients (90%) in Arctic Front group. Procedural outcomes were similar between the two groups, except for lower temperatures during cryoapplications in the POLARx group, for both PVI and LAPWI. The complication rate was low and similar between groups. Conclusion: LAPWI+PVI with the novel POLARx™ Cryoballoon is feasible and safe; the results are comparable with the Arctic Front Advance PRO™ system.

scholarly journals A Second Cryoballoon System- new and improved?

2021 ◽  
Author(s):  
Wilber Su
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Experience ◽  
Atrial Fibrillation Ablation ◽  
Boston Scientific ◽  
Front Advance ◽  
Arctic Front

Generations of cryoballoon transformed the atrial fibrillation ablation landscape. New advancements continue to make cryoballoon more successful and safer treatment. A new cryoballoon PolaRx from Boston Scientific has unique features compared to that of the Medtronic Arctic Front Advance system. Comparison of the two available cryoballoons will require ongoing larger trial and clinical experience.

Real-Time Cylindrical Curvilinear 3-D Ultrasound Imaging

2003 ◽  
Vol 25 (3) ◽  
pp. 137-150 ◽  
Author(s):  
E.C. Pua ◽  
J.T. Yen ◽  
S.W. Smith
Keyword(s):  
Transesophageal Echocardiography ◽  
Real Time ◽  
Phased Array ◽  
Poor Quality ◽  
Field Of View ◽  
Radius Of Curvature ◽  
Two Dimensional ◽  
Color Flow ◽  
Aperture Diameter ◽  
3D Transesophageal Echocardiography

In patients who are obese or exhibit signs of pulmonary disease, standard transthoracic scanning may yield poor quality cardiac images. For these conditions, two-dimensional transesophageal echocardiography (TEE) is established as an essential diagnostic tool. Current techniques in transesophageal scanning, though, are limited by incomplete visualization of cardiac structures in close proximity to the transducer. Thus, we propose a 2D curvilinear array for 3D transesophageal echocardiography in order to widen the field of view and increase visualization close to the transducer face. In this project, a 440 channel 5 MHz two-dimensional array with a 12.6 mm aperture diameter on a flexible interconnect circuit has been molded to a 4 mm radius of curvature. A 75% element yield was achieved during fabrication and an average −6dB bandwidth of 30% was observed in pulse-echo tests. Using this transducer in conjunction with modifications to the beam former delay software and scan converter display software of the our 3D scanner, we obtained cylindrical real-time curvilinear volumetric scans of tissue phantoms, including a field of view of greater than 120° in the curved, azimuth direction and 65° phased array sector scans in the elevation direction. These images were achieved using a stepped subaperture across the cylindrical curvilinear direction of the transducer face and phased array sector scanning in the noncurved plane. In addition, real-time volume rendered images of a tissue mimicking phantom with holes ranging from 1 cm to less than 4 mm have been obtained. 3D color flow Doppler results have also been acquired. This configuration can theoretically achieve volumes displaying 180° by 120.° The transducer is also capable of obtaining images through a curvilinear stepped subaperture in azimuth in conjunction with a rectilinear stepped subaperture in elevation, further increasing the field of view close to the transducer face. Future work includes development of an array for adapting these modifications to a 6 mm diameter en do scope probe.

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