BACKGROUND: Pulmonary vein isolation (PVI) achieved using a cryoballoon has been shown to be safe and effective. This treatment modality has limited effectiveness for treatment of persistent atrial fibrillation (AF). OBJECTIVE: The purpose of this study was to evaluate a combined approach using a cryoballoon for treatment of PVI and focal radiofrequency (RF) left atrial substrate ablation for treatment of persistent AF. METHODS: Twenty-two consecutive patients with persistent AF were included in the study. PVI initially was performed with a cryoballoon. Left atrial complex fractionated atrial electrograms (CFAEs) then were ablated using an RF catheter. Finally, linear ablations using the RF catheter were performed. RESULTS: Eighty-three PVs, including five with left common ostia, were targeted and isolated (100%). Seventy-seven (94%) of 82 PVs targeted with the cryoballoon were isolated, and 5 (6%) required use of RF energy to complete isolation. A mean of 9.7 +/- 2.6 cryoablation applications per patient was needed to achieve PVI. Median time required for cryoablation per vein was 600 seconds, and mean number of balloon applications per vein was 2.5 +/- 1.0. In 19 (86%) patients in whom AF persisted after PVI, CFAE areas were ablated using the RF catheter. Two cases of transient phrenic nerve paralysis occurred. After a single procedure and mean follow-up of 6.0 +/- 2.9 months, 86.4% of patients were AF-free without antiarrhythmic drugs. CONCLUSION: A combined approach of cryoablation and RF ablation for treatment of persistent AF is feasible and is associated with a favorable short-term outcome. Copyright 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
BACKGROUND: Pulmonary vein isolation (PVI) achieved using a cryoballoon has been shown to be safe and effective. This treatment modality has limited effectiveness for treatment of persistent atrial fibrillation (AF). OBJECTIVE: The purpose of this study was to evaluate a combined approach using a cryoballoon for treatment of PVI and focal radiofrequency (RF) left atrial substrate ablation for treatment of persistent AF. METHODS: Twenty-two consecutive patients with persistent AF were included in the study. PVI initially was performed with a cryoballoon. Left atrial complex fractionated atrial electrograms (CFAEs) then were ablated using an RF catheter. Finally, linear ablations using the RF catheter were performed. RESULTS: Eighty-three PVs, including five with left common ostia, were targeted and isolated (100%). Seventy-seven (94%) of 82 PVs targeted with the cryoballoon were isolated, and 5 (6%) required use of RF energy to complete isolation. A mean of 9.7 +/- 2.6 cryoablation applications per patient was needed to achieve PVI. Median time required for cryoablation per vein was 600 seconds, and mean number of balloon applications per vein was 2.5 +/- 1.0. In 19 (86%) patients in whom AF persisted after PVI, CFAE areas were ablated using the RF catheter. Two cases of transient phrenic nerve paralysis occurred. After a single procedure and mean follow-up of 6.0 +/- 2.9 months, 86.4% of patients were AF-free without antiarrhythmic drugs. CONCLUSION: A combined approach of cryoablation and RF ablation for treatment of persistent AF is feasible and is associated with a favorable short-term outcome. Copyright 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Authors: Ioanna Kosmidou; Kyari Sumayin; Thomas Deering; Andrew Wickliffe; Sricharan Kanitpudi; Stephen Prater; Dan Dan Journal: J Atr Fibrillation Date: 2013-10-31
Authors: David Snipelisky; Jordan C Ray; Ryan Ung; Melissa Duart; Christine Kauffman; Fred Kusumoto Journal: J Interv Card Electrophysiol Date: 2014-11-08 Impact factor: 1.900
Authors: Giovanni B Forleo; Domenico G Della Rocca; Carlo Lavalle; Massimo Mantica; Lida P Papavasileiou; Valentina Ribatti; Germana Panattoni; Luca Santini; Andrea Natale; Luigi Di Biase Journal: J Atr Fibrillation Date: 2016-02-29
Authors: Martin Schmidt; Uwe Dorwarth; Florian Straube; Michael Wankerl; Jürgen Krieg; Alexander W Leber; Hans Ullrich Ebersberger; Marcos Daccarett; Armin Huber; Ernst Rummeny; Ellen Hoffmann Journal: Clin Res Cardiol Date: 2012-04-09 Impact factor: 5.460
Authors: Robert M Hayward; Gaurav A Upadhyay; Theofanie Mela; Patrick T Ellinor; Conor D Barrett; E Kevin Heist; Atul Verma; Niteesh K Choudhry; Jagmeet P Singh Journal: Heart Rhythm Date: 2011-03-10 Impact factor: 6.343