Failure to reach the optimal temperature during cryoablation due to refrigerant cylinder problem

Research in Cardiovascular Medicine
Narendra KumarCarl Timmermans

Abstract

Pulmonary vein (PV) isolation is considered as a key to atrial fibrillation (AF) treatment. Cryoballoon ablation is an effective therapy for PV isolation for AF with minimal side effects and was approved by the US Food and Drug Administration (FDA) several years ago. Successful isolation of PVs during cryoablation depends on the balloon temperature and helps in early identification of noneffective cryoballoon applications. A lower balloon temperature has been associated with long-term success in isolation of PVs. At the start of the procedure, the cryoconsole displayed "low refrigerant level". After a few cycles of successful cryoballoon applications, for a fresh application for a new PV, the optimal temperature was not obtained in spite of obtaining good grade of occlusion and ostial positioning for right inferior pulmonary vein (RIPV). Later, immediately after changing the refrigerant cylinder, suitable temperature was obtained. We faced this situation thrice in a span of eight months. Low refrigerant level may cause nonoptimal temperature during cryoablation, which can be resolved by premature change of a gas cylinder.

References

Feb 15, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Alexander FürnkranzKarl Heinz Kuck
Nov 8, 2012·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Anja SchadeBurghard Schumacher
Mar 13, 2014·Circulation. Arrhythmia and Electrophysiology·Florian StraubeEllen Hoffmann
Mar 14, 2014·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Sven KnechtChristian Sticherling
Jul 2, 2014·Interactive Cardiovascular and Thoracic Surgery·Narendra KumarHarry J Crijns
Jul 12, 2014·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Narendra KumarHarry Crijns

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Citations

Jul 15, 2015·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·N KumarJ Maessen

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