scholarly journals Smart Touch Radiofrequency Catheter Ablation versus Cryoballoon Ablation of Pulmonary Veins in Patients with Paroxysmal Atrial Fibrillation

2020 ◽  
Vol 8 (B) ◽  
pp. 563-568
Author(s):  
Walid Shehata Hassan ◽  
Sherief Hamed Zaky ◽  
Khaled Hussein Mohamed ◽  
Moataz Mohammed Ibrahim
Keyword(s):  
Atrial Fibrillation ◽  
Complication Rate ◽  
Paroxysmal Atrial Fibrillation ◽  
Pulmonary Veins ◽  
Cryoballoon Ablation ◽  
Medicine Department ◽  
Free Survival ◽  
Safety And Efficacy ◽  
Significant Difference ◽  
Front Advance

AIM: Evaluation of the safety and efficacy of pulmonary veins isolation in patients with paroxysmal atrial fibrillation (AF) using two new different technologies, cryoballoon (CB) ablation and radiofrequency ablation with contact force (CF)-sensing catheters. METHODS: Prospective single-center evaluation, carried out from January 2016 to June 2018 in Critical Care Medicine Department – Cairo University, comparing CF radiofrequency (Thermocool® SmartTouch, Biosense Webster, Inc.) (CF group) with CB ablation (Arctic Front Advance 28 mm CB, Medtronic, Inc.) (CB group), in regards to procedural safety and efficacy, as well as recurrence at 12 months. Overall, 50 consecutive patients were enrolled (25 in each group). RESULTS: The characteristics of patients of both the groups were similar (46.9 ± 11.2 years, the proportion of women 36%, mean documented AF duration 3 ± 2.3 years, mean CHA2DS2-VASc score 1.4 ± 1.3, and mean HAS-BLED 1.4 ± 0.6). Duration of the procedure was significantly lower in the CB group (171.7 ± 15.24 vs. 199.3 ± 18.94 min, p = 0.002), with a longer duration of fluoroscopy and X-ray exposure in the CB group than the CF group but statistically non-significant difference (58.60 ± 11.57 vs. 48.7 ± 13.86 min and 6273 ± 4934 cGy cm² vs. 6853 ± 5069 cGy cm², p = 0.1 and p = 0.2, respectively). Overall complication rate was similar in both groups: 2 (8%) in each group. At 12 months, AF recurrence occurred in 7 patients (28%) in the CF group and in 9 patients (36%) in the CB group (log rank p = 0.682). CONCLUSION: Pulmonary vein isolation using CF-guided RF and second-generation CB leads to comparable single-procedure arrhythmia-free survival at up to 12 months with similar overall complication rate.

scholarly journals Safety and efficacy of cryoballoon-ablation for atrial fibrillation performed at local hospitals: results of the german register on cryoballoon-ablation in local hospitals (REGIONAL)

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
J Michaelsen ◽  
U Parade ◽  
H Bauerle ◽  
K-D Winter ◽  
U Rauschenbach ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Phrenic Nerve ◽  
Nerve Palsy ◽  
Pulmonary Veins ◽  
Hospital Death ◽  
Cryoballoon Ablation ◽  
Complication Rates ◽  
Community Hospitals ◽  
Phrenic Nerve Palsy ◽  
Safety And Efficacy

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf REGIONAL Background Pulmonary vein isolation (PVI) using cryoballoon ablation (CBA) has become an established procedure for the treatment of symptomatic paroxysmal and persistent atrial fibrillation (AF). The safety and efficacy of PVI at community hospitals with low to moderate case numbers is unknown. Aim To determine safety and efficacy of PVI using CBA performed at community hospitals with limited annual case numbers. Methods 1004 PVI performed consecutively between 01/2019 and 09/2020 at 20 community hospitals (each <100 PVI using CBA/year) for symptomatic paroxysmal AF (n = 563) or persistentAF (n= 441) were included in this registry. CBA was performed considering local standards. Procedural data, efficacy and complications were determined. Results Mean number of PVI using CBA/year was 59 ± 26. Mean procedure time was 90.1 ± 31.6 min and mean fluoroscopy time was 19.2 ± 11.4 min. Isolation of all pulmonary veins could be achieved in 97.9% of patients, early termination of CBA due to phrenic nerve palsy was the most frequent reason for incomplete isolation. There was no in-hospital death. 2 patients (0.2%) suffered a clinical stroke. Pericardial effusion occurred in 6 patients (0.6%), 2 of them (0.2%) required pericardial drainage. Vascular complications occurred in 24 patients (2.4%), in 2 of these patients (0.2%) vascular surgery was required. In 48 patients (4.8 %) phrenic nerve palsy was noticed which persisted up to hospital discharge in 6 patients (0.6%). Conclusions PVI for paroxysmal or persistent AF using CBA can be performed at community hospitals with high efficacy and low complication rates despite low to moderate annual procedure numbers.

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 Particular Morphology of Inferior Pulmonary Veins and Difficulty of Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation

2017 ◽  
Vol 81 (5) ◽  
pp. 668-674 ◽  
Author(s):  
Ryobun Yasuoka ◽  
Takashi Kurita ◽  
Yasuhito Kotake ◽  
Naotaka Hashiguchi ◽  
Koichiro Motoki ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Pulmonary Veins ◽  
Cryoballoon Ablation

scholarly journals Comparing the safety and efficacy of endovascular treatment versus bypass surgery for infrarenal aortic occlusion: a single-center experience

2019 ◽  
Author(s):  
Jingjing Wang ◽  
Jiang Shao ◽  
Chenyang Qiu ◽  
Lijing Fang ◽  
Kang Li ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Complication Rate ◽  
Bypass Surgery ◽  
Aortic Occlusion ◽  
Long Term Results ◽  
Infrarenal Aorta ◽  
Aortofemoral Bypass ◽  
Free Survival ◽  
Safety And Efficacy ◽  
Significant Difference

Abstract Background Infrarenal aortic occlusion (IAO) is a complete occlusion of infrarenal aorta, which is the most complicated and severe subclass of aortoiliac occlusive disease(AIOD). The first-line treatment for IAO is bypass surgery due to its favorable patency rate. As endovascular technique advances, several retrospective studies have reported their endovascular experience for IAO. However, whether endovascular treatment(EVT) is comparable to bypass surgery for IAO required further study. This research was to study the safety and efficacy of EVT for IAO compared to bypass surgery. Methods From 2003 to 2017, 44 consecutive patients with IAO was treated with EVT(n=16) or aortofemoral bypass surgery(n=28). The therapeutic strategy depended on patient’s will and state of health. Demographics, comorbidity, mortality, complication rate, and symptom-free survival proportion was compared by T-tests or chi-square test, to illustrate the safety and efficacy of EVT and bypass surgery. Results The demographics and pre-operative Rutherford classification equally distributed in the two groups(P>0.05). As for technical success, comorbidities, mortality, complication rate, and Rutherford classification after procedures, clinical success, no significant difference was observed(P>0.05). The median post-procedure hospital stay was 4 days in the EVT group and was significantly shorter than that of the bypass, which was 11 days(P<0.05). As for short-term and long-term results, the 1-year, 3-year, and 5-year the cumulative symptom-free survival rates were 85.7%, 85.7% and 85.7% in the EVT group, 100%, 94.1% and 80.7% in the aortofemoral bypass group. There was no significant difference in symptom-free survival rate between the two groups according to log-rank test (P=0.92) Conclusions The safety and efficacy of EVT were comparable to that of anatomic bypass surgery for IAO. EVT could be a feasible option for IAO.

scholarly journals Comparing the safety and efficacy of endovascular treatment versus bypass surgery for infrarenal aortic occlusion: a single-center experience

2019 ◽  
Author(s):  
Jingjing Wang ◽  
Jiang Shao ◽  
Chenyang Qiu ◽  
Lijing Fang ◽  
Kang Li ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Complication Rate ◽  
Bypass Surgery ◽  
Aortic Occlusion ◽  
Long Term Results ◽  
Infrarenal Aorta ◽  
Aortofemoral Bypass ◽  
Free Survival ◽  
Safety And Efficacy ◽  
Significant Difference

Abstract Background: Infrarenal aortic occlusion (IAO) is a complete occlusion of infrarenal aorta, which is the most complicated and severe subclass of aortoiliac occlusive disease (AIOD). The first-line treatment for IAO is bypass surgery due to its favorable patency rate. As endovascular technique advances, several retrospective studies have reported their endovascular experience for IAO. However, whether endovascular treatment(EVT) is comparable to bypass surgery for IAO required further study. This research was to study the safety and efficacy of EVT for IAO compared to bypass surgery. Methods: From 2003 to 2017, 44 consecutive patients with IAO was treated with EVT(n=16) or aortofemoral bypass surgery(n=28). The therapeutic strategy depended on patient’s will and state of health. Demographics, comorbidity, mortality, complication rate, and symptom-free survival proportion was compared by T-tests or chi-square test, to illustrate the safety and efficacy of EVT and bypass surgery. Results:The demographics and pre-operative Rutherford classification equally distributed in the two groups(P>0.05). As for technical success, comorbidities, mortality, complication rate, and Rutherford classification after procedures, clinical success, no significant difference was observed(P>0.05). The median post-procedure hospital stay was 4 days in the EVT group and was significantly shorter than that of the bypass, which was 11 days(P<0.05). As for short-term and long-term results, the 1-year, 3-year, and 5-year the cumulative symptom-free survival rates were 85.7%, 85.7% and 85.7% in the EVT group, 100%, 94.1% and 80.7% in the aortofemoral bypass group.There was no significant difference insymptom-free survival ratebetween the two groups according to log-rank test (P=0.92) Conclusions: The safety and efficacy of EVT were comparable to that of anatomic bypass surgery for IAO . EVT could be a feasible option for IAO.

Abstract 256: Cardiac CT in Ablation of Atrial Fibrillation

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Ala Mohsen ◽  
Nicole Worden ◽  
Manju Bengaluru Jayanna ◽  
Michael Giudici
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Cardiac Ct ◽  
Pulmonary Veins ◽  
Cryoballoon Ablation ◽  
Atrial Fibrillation Recurrence ◽  
Significant Difference ◽  
The Impact

Background: This study aims to determine the impact of pre-procedural cardiac computerized tomography (CT) on procedural efficacy, clinical outcome and complications in patients who undergo radiofrequency or cryo-therapy catheter ablation to eliminate atrial fibrillation (AF). Methods: In this retrospective review, Radiofrequency or Cryoballoon ablation was done on 50 consecutive patients with atrial fibrillation with mean age of 63 (Min 47-Max 86) with paroxysmal (8 2 %) or persistent (18%) AF. Twenty-five patients underwent cryoablation and twenty-five patients underwent Radiofrequency ablation to isolate the pulmonary veins. Procedural and clinical outcomes were compared among patients who underwent catheter ablation with and without pre procedural Cardiac CT. Results: Out of 50 consecutive patients between 01/2014 and 08/2014 there were 26 patients who had a pre-procedural CT scan and 24 patients who did not undergo a pre-procedural CT scan. The mean duration of the procedure (303 ± 93 vs. 271 ± 43 min, P = 0.244) and fluoroscopy time (53 ± 25 vs. 43 ± 17 min, P = 0.086) was similar among patients who did and did not have pre-procedural cardiac CT. The occurrence of complications such as bleeding, pericardial tamponade, pneumothorax, infection and embolic events were also similar in both groups. Repeat ablation was performed in 4 (15%) and 7 (29%) of the patients who did and did not have cardiac CT, respectively (P = 0.249). At 3 months, 5 (19%) and 2(8%) of the patients who did and did not have pre-procedural cardiac CT had atrial fibrillation recurrence (P =0.323). At 12 months, 6 (23%) and 4 (17%) of the patients who did and did not have pre-procedural cardiac CT had atrial fibrillation recurrence (P = 0.467). There was statistically significant difference in Radiation exposure (1805 [IQR 998-2397] vs. 1195 [IQR 738-1363] P=0.0323) between patients who did and did not get pre-procedural cardiac CT, which did not include the radiation added by performing the CT itself. Conclusions: Pre-procedural structural anatomy obtained by cardiac CT scan before catheter ablation for atrial fibrillation in a center where operators used both Radiofrequency and Cryoablation does not appear to have a significant effect on AF recurrence at 3 months or 1 year. The procedural radiation exposure was significantly less in the group that did not have pre-procedure cardiac CT.

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