Additional cryoapplications at the pulmonary vein antrum using a 28-mm second-generation cryoballoon: a pilot study of extra-pulmonary vein ablation

Heart and Vessels
Shinsuke MiyazakiYoshito Iesaka

Abstract

Isolation areas post-28-mm cryoballoon pulmonary vein isolation (CB-PVI) are smaller than post-radiofrequency PV antrum isolation at the left superior PV (LSPV) antrum and recurrent atrial fibrillation (AF) can originate from this area. This pilot study evaluated the impact of additional extra-PV CB applications at the LSPV antrum following conventional CB-PVI. Eighteen paroxysmal AF patients underwent CB-PVI with single 3-min freeze techniques. Following the CB-PVI, 2-min CB applications were added once or twice at the LSPV antrum. Before and after extra-PV ablation, left atrial (LA) 3-D electroanatomical maps were created. Seventy-two total PVs were successfully isolated with 4.2 ± 0.4 applications/patient with 28-mm CBs. The mean LA posterior wall (LAPW) and non-isolated LAPW areas were 14.9 ± 3.6 and 6.9 ± 2.8 cm2, respectively. After 1.6 ± 0.5 mean extra-PV applications, the upper non-isolated LAPW area significantly decreased from 3.3 ± 1.8 to 2.5 ± 1.8 cm2 (p < 0.001). The lowest esophageal temperatures during the extra-PV ablation were 27 °C. The total procedure and fluoroscopic times were 72.8 ± 13.1 and 15.2 ± 5.9 min, respectively. Silent gastric hypomotility was detected in 2/9 patients 1 day later, and mild PV sten...Continue Reading

References

Sep 3, 1998·The New England Journal of Medicine·M HaïssaguerreJ Clémenty
Jun 20, 2006·Journal of the American College of Cardiology·Frédéric SacherPierre Jaïs
Mar 4, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Vivek Y ReddyJeremy N Ruskin
May 16, 2013·Journal of Cardiovascular Electrophysiology·Nicolas CoulombeWilber Su
Jan 7, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Raphaël P MartinsDominique Pavin
Mar 13, 2014·Circulation. Arrhythmia and Electrophysiology·Florian StraubeEllen Hoffmann
Jan 27, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Stefano BordignonKyoung Ryul Julian Chun
Nov 4, 2015·Circulation. Arrhythmia and Electrophysiology·Giuseppe CiconteGian-Battista Chierchia
Mar 5, 2016·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Wilber W SuPaul J Wang
Apr 5, 2016·The New England Journal of Medicine·Karl-Heinz KuckUNKNOWN FIRE AND ICE Investigators
Jun 1, 2016·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Shinsuke MiyazakiYoshito Iesaka
Oct 23, 2016·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Roy M JohnJayanthi N Koneru
Apr 25, 2017·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Shinsuke MiyazakiYoshito Iesaka

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antiarrhythmic Agents: Mechanisms of Action

Understanding the mechanism of action of antiarrhythmic agents is essential in developing new medications as treatment of cardiac arrhythmias is currently limited by the reduced availability of safe and effective drugs. Discover the latest research on Antiarrhythmic Agents: Mechanism of Action here.

Cardiac Conduction System

The cardiac conduction system is a specialized tract of myocardial cells responsible for maintaining normal cardiac rhythm. Discover the latest research on the cardiac conduction system here.

Anti-Arrhythmic Drug Therapies

Anti-arrhythmic drugs are used to prevent abnormal heart rhythms. These medications are used in conditions including, ventricular tachycardia, ventricular fibrillation and atrial fibrillation. Discover the latest research on anti-arrhythmic drug therapies here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.