Anatomic Parameters Predicting Procedural Difficulty and Balloon Temperature Predicting Successful Applications in Individual Pulmonary Veins During 28-mm Second-Generation Cryoballoon Ablation

JACC. Clinical Electrophysiology
Takatsugu KajiyamaYoshito Iesaka

Abstract

This study sought to identify anatomic parameters predicting procedural difficulty in achieving pulmonary vein isolation (PVI) and in-procedural predictors of successful applications during second-generation cryoballoon (CB) ablation. PV anatomies vary and influence the procedural difficulty during CB PVI. In total, 408 initial freezes among 110 patients undergoing PVI for paroxysmal atrial fibrillation using 28-mm second-generation CBs with single 3-min freeze techniques were included. The anatomic parameters were obtained from pre-procedural cardiac computed tomography. The nadir balloon temperature and temperature at the start of the plateau phase were recorded during each freeze. Acute PVI was achieved by initial applications in 335 pulmonary veins (PVs) (82.1%) and touch-up was required in 13 (3.2%). A multivariate analysis revealed that a thinner left lateral ridge (<4.7 mm), higher ovality (>50.5%), and longer PV ostium-bifurcation distance (>26.1 mm) required multiple applications for a successful left superior PVI. Older age (>68 years), and shorter PV ostium-bifurcation distance (<10.4 mm) required multiple applications for a successful right superior and right inferior PVI, respectively. Shorter PVTLs were also assoc...Continue Reading

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Citations

Jan 17, 2020·Journal of Cardiovascular Electrophysiology·Gianluca BorioGian B Chierchia
Dec 29, 2019·Pacing and Clinical Electrophysiology : PACE·Sayaka KurokawaYasuo Okumura
Oct 12, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Yang WangShaolei Yi
Nov 19, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Abhishek BoseDouglas Laidlaw

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