Literature DB >> 27909474

Efficacy, High Procedural Safety And Rapid Optimization Of Cryoballoon Atrial Fibrillation Ablation In The Hands Of A New Operator.

Eberhard Scholz1, Patrick Lugenbiel1, Patrick A Schweizer2, Panagiotis Xynogalos1, Claudia Seyler2, Edgar Zitron2, Rüdiger Becker2, Hugo A Katus2, Dierk Thomas2.   

Abstract

BACKGROUND: Cryoballoon (CB) ablation is successful in eliminating atrial fibrillation (AF).
PURPOSE: The purpose of this study was to assess procedural efficacy and safety of CB ablation performed by a newly trained operator.
METHODS: Forty patients with documented paroxysmal AF (58 ± 11 years, 26 male) undergoing CB catheter ablation were prospectively enrolled.
RESULTS: Electrical pulmonary vein (PV) isolation was achieved in all patients (156 PVs). The primary end point (PV isolation using CB only) was reached in 31 patients (92% PV isolation, 144/156 PVs). In the remaining 9 patients (12 PVs), additional single point cryofocal ablations were required to achieve isolation of all veins (LSPV, n = 5; LIPV, n = 3; LCPV, n = 2; RSPV, n = 1; RIPV, n = 1). There was no vascular access complication, pericardial effusion/tamponade, stroke/transient ischemic attack, phrenic nerve palsy, acute PV stenosis, or atrioesophageal fistula. The procedure duration decreased with experience by 30% from 155 min during the first 10 procedures to 108 min (final 10 treatments). Similar effects were observed with fluoroscopy time (-57%; from 28 min to 12 min), dose area product (-66%; from 22 Gy x cm2 to 8 Gy x cm2), CB time in the left atrium (-24%; from 99 min to 75 min), and cryoenergy delivery time (-19%; from 83 min to 67 min), when comparing cases #1-10 to cases #30-40.
CONCLUSIONS: CB ablation of AF is effective and safe in the hands of a new operator. Procedure and fluoroscopy times decrease with user experience.

Entities:  

Keywords:  Atrial Fibrillation; Catheter Ablation; Cryoballoon; Fluoroscopy; Learning curve

Year:  2016        PMID: 27909474      PMCID: PMC5089487          DOI: 10.4022/jafib.1341

Source DB:  PubMed          Journal:  J Atr Fibrillation        ISSN: 1941-6911


  30 in total

1.  Incidence and characteristics of phrenic nerve palsy following pulmonary vein isolation with the second-generation as compared with the first-generation cryoballoon in 360 consecutive patients.

Authors:  Alexander Fürnkranz; Stefano Bordignon; Boris Schmidt; Laura Perrotta; Daniela Dugo; Manuel De Lazzari; Britta Schulte-Hahn; Bernd Nowak; Julian K R Chun
Journal:  Europace       Date:  2015-01-06       Impact factor: 5.214

2.  Increased incidence of esophageal thermal lesions using the second-generation 28-mm cryoballoon.

Authors:  Andreas Metzner; Andre Burchard; Peter Wohlmuth; Peter Rausch; Alexander Bardyszewski; Christina Gienapp; Roland Richard Tilz; Andreas Rillig; Shibu Mathew; Sebastian Deiss; Hisaki Makimoto; Feifan Ouyang; Karl-Heinz Kuck; Erik Wissner
Journal:  Circ Arrhythm Electrophysiol       Date:  2013-06-07

3.  Asymptomatic pulmonary vein stenosis after cryoballoon catheter ablation of paroxysmal atrial fibrillation.

Authors:  Dierk Thomas; Hugo A Katus; Frederik Voss
Journal:  J Electrocardiol       Date:  2010-12-13       Impact factor: 1.438

4.  Single transseptal big Cryoballoon pulmonary vein isolation using an inner lumen mapping catheter.

Authors:  Kr Julian Chun; Stefano Bordignon; Melanie Gunawardene; Verena Urban; Mehmet Kulikoglu; Britta Schulte-Hahn; Bernd Nowak; Boris Schmidt
Journal:  Pacing Clin Electrophysiol       Date:  2012-08-06       Impact factor: 1.976

5.  Phrenic nerve paralysis during cryoballoon ablation for atrial fibrillation: a comparison between the first- and second-generation balloon.

Authors:  Ruben Casado-Arroyo; Gian-Battista Chierchia; Giulio Conte; Moisés Levinstein; Juan Sieira; Moises Rodriguez-Mañero; Giacomo di Giovanni; Yannis Baltogiannis; Kristel Wauters; Carlo de Asmundis; Andrea Sarkozy; Pedro Brugada
Journal:  Heart Rhythm       Date:  2013-07-24       Impact factor: 6.343

6.  Improved procedural efficacy of pulmonary vein isolation using the novel second-generation cryoballoon.

Authors:  Alexander Fürnkranz; Stefano Bordignon; Boris Schmidt; Melanie Gunawardene; Britta Schulte-Hahn; Verena Urban; Frank Bode; Bernd Nowak; Julian K R Chun
Journal:  J Cardiovasc Electrophysiol       Date:  2013-02-11

7.  Cryoballoon ablation of pulmonary veins for paroxysmal atrial fibrillation: first results of the North American Arctic Front (STOP AF) pivotal trial.

Authors:  Douglas L Packer; Robert C Kowal; Kevin R Wheelan; James M Irwin; Jean Champagne; Peter G Guerra; Marc Dubuc; Vivek Reddy; Linda Nelson; Richard G Holcomb; John W Lehmann; Jeremy N Ruskin
Journal:  J Am Coll Cardiol       Date:  2013-03-21       Impact factor: 24.094

8.  Circumferential pulmonary vein isolation with the cryoballoon technique results from a prospective 3-center study.

Authors:  Thomas Neumann; Jürgen Vogt; Burghard Schumacher; Anja Dorszewski; Malte Kuniss; Hans Neuser; Klaus Kurzidim; Alexander Berkowitsch; Marcus Koller; Johannes Heintze; Ursula Scholz; Ulrike Wetzel; Michael A E Schneider; Dieter Horstkotte; Christian W Hamm; Heinz-Friedrich Pitschner
Journal:  J Am Coll Cardiol       Date:  2008-07-22       Impact factor: 24.094

Review 9.  The pathology and treatment of cardiac arrhythmias: focus on atrial fibrillation.

Authors:  Constanze Schmidt; Jana Kisselbach; Patrick A Schweizer; Hugo A Katus; Dierk Thomas
Journal:  Vasc Health Risk Manag       Date:  2011-03-31

10.  The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study.

Authors:  Kyoung-Ryul Julian Chun; Boris Schmidt; Andreas Metzner; Roland Tilz; Thomas Zerm; Ilka Köster; Alexander Fürnkranz; Buelent Koektuerk; Melanie Konstantinidou; Matthias Antz; Feifan Ouyang; Karl Heinz Kuck
Journal:  Eur Heart J       Date:  2008-12-24       Impact factor: 29.983

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