New cryoballoon atrial fibrillation ablation, is it the time for changes?

2018 ◽  
Vol 2 (47) ◽  
pp. 16-21
Author(s):  
Grzegorz Hordyński ◽  
Agnieszka Wojdyła-Hordyńska
Keyword(s):  
Atrial Fibrillation ◽  
Best Practice ◽  
First Generation ◽  
Second Generation ◽  
Atrial Fibrillation Ablation ◽  
Arctic Front ◽  
Procedural Recommendations

Since the release of the second-generation cryoballoon (CB2; Arctic Front AdvanceTM, Medtronic Inc) and its modifications with improved cooling characteristics, the technique, dosing, and complication profile is significantly different from that of the first-generation cryoballoon. Several reports of CB2 procedural recommendations have been presented. Hereby, the literature summary was performed and the technical and procedural study based regimen delivered. The best practice overview presents large centers contemporary techniques for safer and more effective outcomes and perhaps new approved recommendations for atrial fibrillation treatment.

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.

Long‐term outcomes of pulmonary vein isolation using second‐generation cryoballoon during atrial fibrillation ablation

2019 ◽  
Vol 42 (7) ◽  
pp. 910-921 ◽  
Author(s):  
Ugur Canpolat ◽  
Duygu Kocyigit ◽  
Muhammed Ulvi Yalcin ◽  
Cem Coteli ◽  
Yusuf Ziya Sener ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Second Generation ◽  
Atrial Fibrillation Ablation ◽  
Long Term Outcomes

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

Safety and efficacy of persistent atrial fibrillation ablation using the second-generation cryoballoon

2018 ◽  
Vol 107 (7) ◽  
pp. 570-577 ◽  
Author(s):  
Kivanc Yalin ◽  
Amr Abdin ◽  
Evgeny Lyan ◽  
Noureddin Sawan ◽  
Spyridon Liosis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Second Generation ◽  
Persistent Atrial Fibrillation ◽  
Atrial Fibrillation Ablation ◽  
Safety And Efficacy
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