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.

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.

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.

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 Comparison of Using Second-Generation Cryoballoon and Radiofrequency Catheter for Atrial Fibrillation Ablation in Patients With the Common Ostium of Inferior Pulmonary Veins

2022 ◽  
Vol 8 ◽  
Author(s):  
Jia-hui Li ◽  
Hai-yang Xie ◽  
Qi Sun ◽  
Xiao-gang Guo ◽  
Yan-qiao Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Second Generation ◽  
Pulmonary Veins ◽  
Cryoballoon Ablation ◽  
Safe Alternative ◽  
Anatomical Characteristics ◽  
Procedural Time ◽  
The Common ◽  
Procedural Outcomes

Aims: To compare the procedural outcomes of cryoballoon ablation (CBA) and radiofrequency ablation (RFA) in atrial fibrillation (AF) patients with the common ostium of inferior pulmonary veins (COIPV) and to explore the effect of COIPV on CBA performance through the assessment of anatomical factors.Methods: A total of 18 AF patients with COIPV were included. Pulmonary vein isolation (PVI) was performed with second-generation CBA or RFA. The anatomical characteristics of COIPV and procedural outcomes were collected.Results: The prevalence of COIPV was 0.82% in the enrolled population. PVI was achieved in all pulmonary veins (PVs) without any complications. The “tricircle” strategy was applied for RFA, and the segmental freeze strategy was performed for CBA. Compared with RFA, CBA had shorter procedural time (median: 53.0 vs. 78.0 min, p < 0.001) and longer fluoroscopy time (median: 13.5 vs. 6.0 min, p < 0.001). Higher ovality index of the ostium was seen in patients with ≥4 freezes in inferior PVs [IPVs; 0.95 (0.78–1.05) vs. 0.49 (0.21–0.83), p = 0.047]. During a median of 23.5 months of follow-up, the atrial arrhythmias-free survival after the procedure was comparable between CBA and RFA (p = 0.729).Conclusion: The second-generation CBA is an efficient and safe alternative for RFA in AF patients with COIPV. Anatomical characteristics of COIPV bring the challenge to the procedure performance of RFA and CBA.

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.

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