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Goto K, Miyazaki S, Negishi M, Ikenouchi T, Yamamoto T, Kawamura I, Nishimura T, Takamiya T, Tao S, Takigawa M, Sasano T. Distribution of antral lesions with the novel size-adjustable cryoballoon for pulmonary vein isolation and the differences based on left atrial remodeling. J Cardiovasc Electrophysiol 2024. [PMID: 39169533 DOI: 10.1111/jce.16415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 07/29/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024]
Abstract
INTRODUCTION The novel cryoballoon with 28 mm or 31 mm adjustable diameters, aims to achieve a wide antral pulmonary vein isolation (PVI). However, the distribution of antral lesions and their variations based on left atrial (LA) remodeling require further clarification. METHODS We evaluated 22 patients (67 [59.5-74.8] years, 19 males) who underwent PVI of atrial fibrillation (AF) (13 paroxysmal AF [PAF] and 9 non-PAF) using size-adjustable cryoballoons. LA electro-anatomical mapping was performed post-PVI with three-dimensional mapping systems. We assessed the shapes of the LA and pulmonary veins (PVs) and the distribution of isolated areas (IAs), comparing the results between PAF and non-PAF patients. RESULTS In the left PVs (LPVs), the distance between the PV orifice and IA edge (PVos-IA) was larger on the roof and posterior segments (~15 mm) but relatively smaller on the anterior segment near the PV ridge (<10 mm). For the right PVs (RPVs), it was more extensive in the posterior segment (10-15 mm). Comparing PAF and non-PAF, there were no significant differences in the PVos-IA except for the right posterior-carina segment, antrum IA (LPVs: 5.9 ± 1.6 vs. 5.8 ± 0.8 cm², p = .81; RPVs: 4.8 ± 2.3 vs. 4.8 ± 1.2 cm², p = .81), distances between the right and left IAs on the LA posterior wall (LAPW), and un-isolated LAPW area (9.0 ± 4.9 vs. 9.9 ± 2.5 cm², p = .62). No individual PVIs were observed in either group. Two patients exhibited overlapping IAs on the roof, and one patient who underwent 31 mm balloon applications for all PVs exhibited an LAPW isolation. CONCLUSION The size-adjustable cryoballoon achieved a wide antral PVI even in non-PAF patients.
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Affiliation(s)
- Kentaro Goto
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Miho Negishi
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Ikenouchi
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tasuku Yamamoto
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Iwanari Kawamura
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takuro Nishimura
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomomasa Takamiya
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Susumu Tao
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masateru Takigawa
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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Erkapic D, Roussopoulos K, Aleksic M, Sözener K, Kostev K, Rosenbauer J, Sossalla S, Gündüz D, Labenz J, Tanislav C, Weipert KF. Cryoballoon-Assisted Pulmonary Vein Isolation and Left Atrial Roof Ablation Using a Simplified Sedation Strategy without Esophageal Temperature Monitoring: No Notable Thermal Esophageal Lesions and Low Arrhythmia Recurrence Rates after 2 Years. Diagnostics (Basel) 2024; 14:1370. [PMID: 39001260 PMCID: PMC11241260 DOI: 10.3390/diagnostics14131370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 06/23/2024] [Accepted: 06/25/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Atrial fibrillation (AF) ablation is increasingly effective for managing heart rhythm but poses risks like esophageal fistulas. Minimizing esophageal thermal lesions while simplifying procedures is crucial. METHODS This prospective study involved 100 consecutive AF patients undergoing cryoballoon ablation with simplified sedation, without esophageal temperature monitoring. Patients with paroxysmal AF (Group A) received pulmonary vein isolation only, while those with persistent AF (Group B) also had left atrial roof ablation. Gastroesophageal endoscopy was performed post-procedure to detect lesions, and cardiological follow-ups were conducted at 3, 12, and 24 months. RESULTS The cohort included 69% men, with a median age of 65.5 years. Post-ablation endoscopy was performed in 92 patients; esophageal lesions were found in 1.1% of Group A and none of Group B. GERD was diagnosed in 14% of patients, evenly distributed between groups and not linked to lesion occurrence. Gastric hypomotility was observed in 16% of patients, with no significant difference between groups. At 24 months, arrhythmia-free survival was 88% in Group A and 74% in Group B. CONCLUSION Cryoballoon-assisted pulmonary vein isolation, with or without additional left atrial roof ablation and without esophageal temperature monitoring during a simplified sedation strategy, shows low risk of esophageal thermal injury and effective ablation outcomes.
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Affiliation(s)
- Damir Erkapic
- Department of Cardiology, Rhythmology and Angiology, Medical Clinic II, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany; (K.R.); (M.A.); (K.S.); (J.R.); (D.G.); (K.F.W.)
- Department of Cardiology and Angiology, Medical Clinic I, University Hospital Giessen, 35392 Giessen, Germany;
| | - Konstantinos Roussopoulos
- Department of Cardiology, Rhythmology and Angiology, Medical Clinic II, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany; (K.R.); (M.A.); (K.S.); (J.R.); (D.G.); (K.F.W.)
| | - Marko Aleksic
- Department of Cardiology, Rhythmology and Angiology, Medical Clinic II, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany; (K.R.); (M.A.); (K.S.); (J.R.); (D.G.); (K.F.W.)
| | - Korkut Sözener
- Department of Cardiology, Rhythmology and Angiology, Medical Clinic II, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany; (K.R.); (M.A.); (K.S.); (J.R.); (D.G.); (K.F.W.)
| | - Karel Kostev
- Department of Epidemiology, Philipps-University Marburg, 35037 Marburg, Germany;
| | - Josef Rosenbauer
- Department of Cardiology, Rhythmology and Angiology, Medical Clinic II, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany; (K.R.); (M.A.); (K.S.); (J.R.); (D.G.); (K.F.W.)
| | - Samuel Sossalla
- Department of Cardiology and Angiology, Medical Clinic I, University Hospital Giessen, 35392 Giessen, Germany;
| | - Dursun Gündüz
- Department of Cardiology, Rhythmology and Angiology, Medical Clinic II, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany; (K.R.); (M.A.); (K.S.); (J.R.); (D.G.); (K.F.W.)
- Department of Cardiology and Angiology, Medical Clinic I, University Hospital Giessen, 35392 Giessen, Germany;
| | - Joachim Labenz
- Department of Gastroenterology, Medical Clinic I, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany;
| | - Christian Tanislav
- Department of Geriatrics and Neurology, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany;
| | - Kay Felix Weipert
- Department of Cardiology, Rhythmology and Angiology, Medical Clinic II, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany; (K.R.); (M.A.); (K.S.); (J.R.); (D.G.); (K.F.W.)
- Department of Cardiology and Angiology, Medical Clinic I, University Hospital Giessen, 35392 Giessen, Germany;
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Kujiraoka H, Suzuki A, Kawaguchi N, Amemiya M, Sakai E, Setoguchi M, Kawamoto S, Sato K, Ochida M, Watanabe S, Nakajima J, Yoshikawa S, Usui M, Sasano T, Yamauchi Y. Raise-up technique for the creation of left atrial roof lesion: A useful technique with cryoballoon for persistent atrial fibrillation. J Cardiovasc Electrophysiol 2024; 35:1129-1139. [PMID: 38556747 DOI: 10.1111/jce.16267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Recent studies have reported the efficacy of the cryoballoon (CB)-guided left atrial roof block line (LARB) creation in patients with persistent atrial fibrillation (AF). However, it can be technically challenging to attach the balloon to the left atrial (LA) roof due to its anatomical variations. We designed a new procedure called the "Raise-up Technique," which may facilitate the firm adhesion of the CB to the LA roof during freezing. This study aimed to evaluate the efficacy of the Raise-up technique in LARB creation. METHODS AND RESULTS In total, 100 consecutive patients with persistent AF who underwent CB-LARB creation were enrolled. Fifty-seven patients underwent LARB creation using the Raise-up technique (Raise-up group), and the remaining 43 did not use it (control group). The Raise-up technique was performed as follows: An Achieve catheter was inserted as deeply as possible into the upper branch of the right superior pulmonary vein to anchor the CB. The balloon was placed below the targeted site on the LA roof and frozen. When the temperature of the CB reached approximately -10°C and the CB was easier to attach to the LA tissue, the CB was raised and pressed against the LA roof immediately by sheath advancement. Then the balloon could be in firm contact with the target site on the roof. If necessary, additional sheath advancement after sufficient freezing (-20°C to -30°C) was allowed the CB to have more firm and broad contact with the target site. LARB creation without touch-up ablation was achieved in 54 of 57 patients (94.7%) in the Raise-up group and 33 of 43 patients (76.7%) in the control group (p < .05). The lesion size of the LARB in the Raise-up group was significantly larger than that in the control group (15.2 cm2 vs. 12.8 cm2, p < .05). Moreover, the width of the LARB lesion in the Raise-up group was wider than that in the control group (32.0 mm vs. 26.6 mm, p < .05). CONCLUSION The Raise-up technique enabled the creation of seamless and thick LARB lesions with a single stroke. In addition, the CB-LARB lesions created using the Raise-up technique tended to be large, resulting in extensive debulking of the LA posterior wall arrhythmia substrates. In CB ablation for persistent AF, the Raise-up technique can be considered one of the key strategies for LARB creation.
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Affiliation(s)
| | - Atsushi Suzuki
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | | | - Miki Amemiya
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Eiko Sakai
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Mirei Setoguchi
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Shiho Kawamoto
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Kuniyoshi Sato
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Mie Ochida
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Shingo Watanabe
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Jun Nakajima
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Shunji Yoshikawa
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Michio Usui
- Department of Cardiology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuteru Yamauchi
- Heart Center, Japan Red Cross Yokohama City Bay Hospital, Yokohama, Japan
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Çöteli C, Dural M, Yorgun H, Aytemir K. Cryoballoon ablation of non-PV triggers in persistent atrial fibrillation. Pacing Clin Electrophysiol 2024; 47:66-79. [PMID: 37971717 DOI: 10.1111/pace.14878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/21/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
Cryoballoon-based catheter ablation has emerged as an efficacious and safe therapeutic intervention for patients with paroxysmal atrial fibrillation (PAF). PAF is primarily associated with the triggers in the pulmonary vein (PV). However, persistent atrial fibrillation (PeAF) is a complex condition that involves changes in the atrial substrate and the presence of non-PV triggers. Therefore, a comprehensive treatment approach is necessary for patients with PeAF. Utilizing a 3D electroanatomical map, the radiofrequency-based ablation technique adeptly identifies and targets the atrial substrate and non-PV triggers. On the other hand, the cryoballoon-based AF ablation was initially designed for PV isolation. However, its single-shot feature makes it a great choice for electrophysiologists looking to address non-PV triggers. It is possible to target the left atrial appendage (LAA), superior vena cava (SVC), left atrial roof, and posterior wall using the apparatus's unique configuration and ablation abilities. This review focuses on the increasing literature regarding cryoballoon-based methods for non-PV trigger ablation. Specifically, it delves into the technical procedures used to isolate the LAA, SVC, and ablate the left atrial roof and posterior wall.
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Affiliation(s)
- Cem Çöteli
- Faculty of Medicine, Department of Cardiology, Hacettepe University, Ankara, Turkey
| | - Muhammet Dural
- Faculty of Medicine, Department of Cardiology, Osmangazi University, Eskişehir, Turkey
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Hikmet Yorgun
- Faculty of Medicine, Department of Cardiology, Hacettepe University, Ankara, Turkey
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kudret Aytemir
- Faculty of Medicine, Department of Cardiology, Hacettepe University, Ankara, Turkey
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Aryana A, D’Avila A. Emerging Tools and Techniques for Catheter Ablation of Cardiac Arrhythmias: A 2024 Update. J Innov Card Rhythm Manag 2024; 15:5718-5727. [PMID: 38304094 PMCID: PMC10829418 DOI: 10.19102/icrm.2024.15019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Affiliation(s)
- Arash Aryana
- Mercy General Hospital and Dignity Health Heart and Vascular Institute, Sacramento, CA, USA
| | - André D’Avila
- The Harvard Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Shigeta T, Okishige K, Murata K, Oda A, Arai H, Sagawa Y, Kurabayashi M, Goya M, Sasano T, Yamauchi Y. How to perform effective cryoballooon ablation of the left atrial roof: Considerations after experiencing more than 1000 cases. J Cardiovasc Electrophysiol 2023; 34:2484-2492. [PMID: 37752712 DOI: 10.1111/jce.16082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/04/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Cryoballoon ablation (CBA) of the left atrial (LA) roof in addition to a pulmonary vein isolation has been expected to improve the clinical outcomes post-atrial fibrillation (AF) ablation. We demonstrated the characteristics and efficacy of CBA of the LA roof through our experience with a large volume of procedures. METHODS Among 1036 AF ablation procedures with CBA of the LA roof, 834 patients who underwent a de novo ablation were analyzed. RESULTS Complete LA roof line conduction block was obtained in 767 patients (92.0%) solely by CBA (Group A). Compared with the other patients (Group B), the mean nadir balloon temperature during CBA of the LA roof (-44.5 ± 5.6°C for Group A vs. -40.5 ± 7.5°C for Group B, p < .01) and number of cryoballoon applications during the LA roof ablation with a circular mapping catheter located in the left superior pulmonary vein (1.3 ± 0.8 for Group A vs. 1.6 ± 1.0 for Group B, p = .02) were significantly lower in Group A. A multivariate analysis revealed that those were predictors of a complete LA roof conduction block after only CBA. The 1-year Kaplan-Meier atrial arrhythmia free rate estimates were 80.6% for Group A and 59.0% for Group B (p < .01). CONCLUSION Complete LA roof line conduction block could be obtained with a cryoballoon without touch-up ablation in most cases. The LA roof CBA with a circular mapping catheter located in the right superior pulmonary vein was preferable to obtaining complete LA roof conduction block, which was important with regard to the clinical outcomes.
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Affiliation(s)
- Takatoshi Shigeta
- Heart Center, Japan Red Cross Yokohama City Bay Hospital, Yokohama City, Japan
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kaoru Okishige
- Heart Center, Japan Red Cross Yokohama City Bay Hospital, Yokohama City, Japan
| | - Kazuya Murata
- Heart Center, Japan Red Cross Yokohama City Bay Hospital, Yokohama City, Japan
| | - Atsuhito Oda
- Heart Center, Japan Red Cross Yokohama City Bay Hospital, Yokohama City, Japan
| | - Hirofumi Arai
- Heart Center, Japan Red Cross Yokohama City Bay Hospital, Yokohama City, Japan
| | - Yuichiro Sagawa
- Heart Center, Japan Red Cross Yokohama City Bay Hospital, Yokohama City, Japan
| | - Manabu Kurabayashi
- Heart Center, Japan Red Cross Yokohama City Bay Hospital, Yokohama City, Japan
| | - Masahiko Goya
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuteru Yamauchi
- Heart Center, Japan Red Cross Yokohama City Bay Hospital, Yokohama City, Japan
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Lin YZ, Peng YM, Lian LH, Zhang JC, Wu MQ, Yang ZP, Chen JQ, Liao XW, Chen L. An evaluation of the clinical efficacy of the application of 28mm cryoballoon for linear ablation of left atrial apex combined with enlarged pulmonary vein vestibule ablation for persistent atrial fibrillation. Hellenic J Cardiol 2023; 72:15-23. [PMID: 37019212 DOI: 10.1016/j.hjc.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE to retrospectively investigate the efficacy and safety of the application of 28 mm cryoballoon for pulmonary vein electrical isolation (PVI) combined with top left atrial linear ablation and pulmonary vein vestibular expansion ablation for persistent atrial fibrillation. METHODS From July 2016 to December 2020, 413 patients diagnosed with persistent atrial fibrillation were evaluated, including 230 (55.7%) in the PVI group (PVI only) and 183 (44.3%) in the PVIPLUS group (PVI plus ablation of the left atrial apex and pulmonary vein vestibule). The safety and efficacy of the two groups were retrospectively analyzed. RESULTS The AF/AT/AFL-free survival rates at 6, 12, 18, 24 and 30 months after procedure was 86.6%, 72.6%, 70.0%, 61.1% and 56.3% in the PVI group and 94.5%, 87.0%, 84.1%, 75.0% and 67.9% in the PVIPLUS group, respectively. At 30 months after procedure, the AF/AT/AFL-free survival rate was significantly higher in the PVIPLUS group than in the PVI group (P = 0.036; HR:0.63; 95% CI:0.42 to 0.95). CONCLUSION The application of 28-mm cryoballoon for pulmonary vein electrical isolation combined with linear ablation of the left atrial apex and expanded ablation of the pulmonary vein vestibule improves the outcome of persistent atrial fibrillation.
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Affiliation(s)
- Ya-Zhou Lin
- Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian 350000, PR China
| | - Yi-Ming Peng
- Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian 350000, PR China
| | - Lian-Hua Lian
- Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian 350000, PR China
| | - Jian-Cheng Zhang
- Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian 350000, PR China
| | - Mei-Qiong Wu
- Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian 350000, PR China
| | - Zhi-Ping Yang
- Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian 350000, PR China
| | - Jian-Quan Chen
- Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian 350000, PR China
| | - Xue-Wen Liao
- Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian 350000, PR China
| | - Lin Chen
- Department of Cardiology, Provincial Clinical Medicine College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian 350000, PR China.
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Erkapic D, Aleksic M, Roussopoulos K, Weipert KF, Sözener K, Kostev K, Allendörfer J, Rosenbauer J, Guenduez D, Tanislav C. Microembolizations in the Arterial Cerebral Circulation in Patients with Atrial Fibrillation Ablation Using the Cryoballoon Technique-Protocol and Methodology of a Prospective Observational Study. Diagnostics (Basel) 2023; 13:diagnostics13091660. [PMID: 37175051 PMCID: PMC10178285 DOI: 10.3390/diagnostics13091660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
There is considerable uncertainty regarding the impact of microembolic signals (MESs) on neuropsychological abilities in patients receiving pulmonary vein isolation and beyond using the cryoballoon technique. We conducted the largest prospective observational study on this topic, providing insights into the gradual unmasking of procedure-related MESs and their impacts on neuropsychological outcomes. MESs were continuously detected periprocedurally using transcranial Doppler ultrasonography. Neuropsychological status was evaluated comprehensively using the CERAD Plus test battery, which consists of 11 neuropsychological subtests. Patients with atrial fibrillation were included in the study with an equal distribution (50:50) of paroxysmal or persistent presentations. Of 167 consecutive eligible patients, 100 were included within the study enrollment period from February 2021 to August 2022. The study, including the documentation of all follow-up visits, ended in November 2022. This paper focuses on describing the study protocol and methodology and presenting the baseline data.
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Affiliation(s)
- Damir Erkapic
- Department of Cardiology, Rhythmology and Angiology, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany
- Department of Cardiology and Angiology, University Clinic of Giessen, 35392 Giessen, Germany
| | - Marko Aleksic
- Department of Cardiology, Rhythmology and Angiology, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany
| | - Konstantinos Roussopoulos
- Department of Cardiology, Rhythmology and Angiology, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany
| | - Kay Felix Weipert
- Department of Cardiology, Rhythmology and Angiology, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany
| | - Korkut Sözener
- Department of Cardiology, Rhythmology and Angiology, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany
- Department of Rhythmology, Klinikum Hanau, 63450 Hanau, Germany
| | - Karel Kostev
- Epidemiology, IQVIA, Unterschweinstiege 2-14, 60549 Frankfurt am Main, Germany
| | | | - Josef Rosenbauer
- Department of Cardiology, Rhythmology and Angiology, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany
| | - Dursun Guenduez
- Department of Cardiology, Rhythmology and Angiology, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany
- Department of Cardiology and Angiology, University Clinic of Giessen, 35392 Giessen, Germany
| | - Christian Tanislav
- Department of Geriatrics and Neurology, Diakonie Klinikum Jung Stilling, 57074 Siegen, Germany
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Transmural lesion formation after left atrial roof cryoballoon ablation: Insight from simultaneous high-density epicardial mapping. Heart Rhythm O2 2023. [DOI: 10.1016/j.hroo.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
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10
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Mizutani Y, Yanagisawa S, Fujiwara G, Kasai Y, Tajima A, Makino Y, Suzuki H, Hiramatsu T, Ichimiya H, Uchida Y, Watanabe J, Kanashiro M, Inden Y, Murohara T. Evaluation of the direction and extent of ice formation during cryoballoon ablation: an experimental study. J Interv Card Electrophysiol 2022; 66:981-989. [PMID: 36336724 DOI: 10.1007/s10840-022-01411-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/31/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The distal hemisphere of a balloon is generally cooled during cryoapplication. However, a wide ablation area can be acquired after cryoballoon ablation. This study aimed to evaluate the extent of ice formation on two types of balloon surfaces through experimental and simulation studies. METHODS A standard cryoballoon (SCB; Arctic Front Advance Pro, Medtronic) and novel cryoballoon (NCB; POLARx, Boston Scientific) were frozen for 240 s in 36 °C normal saline solution to observe ice formation on the balloon surface. Pieces of porcine tissue were placed between the upper and lower sides of the balloon, and the balloon was frozen in the horizontal direction for 240 s in 20 attempts (10 for SCB and NCB each). The measured areas of ice formation were evaluated and compared between the upper and lower sides of each balloon. RESULTS Ice formation was greater on the lower side of the balloon than on the upper side. A larger area of ice formation in the tissue slab was observed on the lower side than on the upper side in both balloons, and the ice formation extended to the proximal hemisphere on the lower side of the balloon. The ice formation area in the NCB was significantly larger than that in SCB. CONCLUSIONS Ice formation was significantly greater on the lower side of the cryoballoon than on the upper side and extended to the proximal hemisphere of the balloon, which might facilitate the acquisition of a wide ablation area on the left atrial posterior wall after cryoballoon ablation. Different ice formation after cryoballoon ablation Greater ice formation on the lower side of cryoballoon and an extensive ice formation in the proximal hemisphere, especially in novel cryoballoon.
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Affiliation(s)
- Yoshiaki Mizutani
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan.
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
| | - Satoshi Yanagisawa
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Gen Fujiwara
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan
| | - Yosuke Kasai
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan
| | - Atomu Tajima
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan
| | - Yuichiro Makino
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan
| | - Hitomi Suzuki
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan
| | - Takatsugu Hiramatsu
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan
| | - Hitoshi Ichimiya
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan
| | - Yasuhiro Uchida
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan
| | - Junji Watanabe
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan
| | - Masaaki Kanashiro
- Department of Cardiology, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi, Mie, Japan
| | - Yasuya Inden
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Michas G, Magriplis E, Micha R, Chourdakis M, Koutelidakis A, Dimitriadis G, Panagiotakos D, Zampelas A. WITHDRAWN: Prevalence and factors associated with smoking in a nationally representative sample of Greek adults: The Hellenic National Nutrition and Health Survey (HNNHS). Hellenic J Cardiol 2022:S1109-9666(22)00068-9. [PMID: 35605945 DOI: 10.1016/j.hjc.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 05/02/2022] [Accepted: 05/14/2022] [Indexed: 11/18/2022] Open
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.hjc.2022.05.005. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
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Affiliation(s)
- George Michas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Renata Micha
- Department of Food Science and Nutrition, School of Agricultural Sciences, University of Thessaly, 43 100, Karditsa, Greece
| | - Michail Chourdakis
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54 124 Thessaloniki, Greece
| | - Antonis Koutelidakis
- Department of Food Science and Nutrition, University of Aegean, Mytilini, Greece
| | - George Dimitriadis
- 2(nd) 1Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens, Attikon University Hospital, Haidari, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University, Athens, Eleftheriou Venizelou 70, 176 76 Athens, Greece
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece.
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12
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Cryoballoon atrial fibrillation ablation experience in Japan. Curr Opin Cardiol 2022; 37:68-73. [PMID: 34857716 DOI: 10.1097/hco.0000000000000910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW In Japan, cryoballoon ablation has been widely accepted and more than 70 000 patients have undergone pulmonary vein isolation using this novel technology since the introduction. This review focused on the current status of cryoballoon ablation in Japan and clarified the characteristics as compared to Europe and the United States. RECENT FINDINGS The number of atrial fibrillation patients undergoing cryoballon ablation has rapidly increased over the last 6 years. Most of the Japanese physicians consider the indication of cryoballoon ablation based on the anatomy of the pulmonary veins and left atrium evaluated on preprocedural computed tomography, and often perform adjunctive radiofrequency ablation after the pulmonary vein isolation. The reported overall efficacy and safety were similar to that in Europe and the United States; however, there are some distinctive complications of the cryoballoon procedure in Japan, such as air embolisms, gastric hypomotility and coronary artery spasms. SUMMARY Currently, the cryoballoon pulmonary vein isolation is widely accepted in Japan owing to the low incidence of lethal complications, shorter procedure time and acceptable single procedure atrial fibrillation freedom.
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Miyazaki S, Sekihara T, Hasegawa K, Mukai M, Aoyama D, Nodera M, Tada H. The feasibility and safety of substrate modification on the left atrial roof area using a cryoballoon in atrial fibrillation ablation. Int J Cardiol 2021; 350:41-47. [PMID: 34954279 DOI: 10.1016/j.ijcard.2021.12.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/27/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Data on additional substrate modification using a cryoballoon beyond cryoballoon pulmonary vein isolation (CB-PVI) is limited. We sought to evaluate the efficacy and safety of substrate modification on the left atrial roof area using CBs (LAR-CBs) for atrial fibrillation (AF) patients. METHODS Eighty-one AF patients (70.0[62.5-77.0] years, 33 paroxysmal AF[PAF], 48 non-PAF) underwent LAR-CBs following CB-PVIs. Voltage maps were created with a high-resolution mapping system. Roof line conduction block was evaluated during the repeat procedure. RESULTS The total number of applications for the CB-PVI and LAR-CB were 5.0 ± 1.2 and 3.8 ± 0.7, and both were significantly greater in non-PAF than PAF patients. LA roof areas had continuous scar in 61/79(77.2%) patients, and the mean balloon temperature was significantly lower in patients with continuous scar than those without (-39.3 ± 3.8 vs. 36.0 ± 4.6 °C, p = 0.004). The single procedure 1-year AF freedom was 87.6% (7.5% on antiarrhythmic drug) and was similar between PAF and non-PAF patients (p = 0.14). Twelve (14.8%) patients underwent a second procedure 5.5(2.2-7.5) months later, and a mean of 1.3 ± 0.5 PVs were reconnected in 7/12(58.3%) patients. Electrical conduction block across the roof line was proven in 3/12(25.0%) patients. There were 6(7.4%) complications related to the procedures, including iatrogenic roof dependent atrial tachycardia, takotsubo cardiomyopathy, and severe pericarditis in 1, 1, and 2 patients, respectively. CONCLUSIONS LA roof area substrate modification using CBs yielded a high arrhythmia freedom after single procedures. However, a low incidence of electrical conduction block across the line during the chronic phase and delayed complications were the major concerns.
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Affiliation(s)
- Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
| | - Takayuki Sekihara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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14
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Miyazaki S, Hasegawa K, Mukai M, Aoyama D, Nodera M, Uzui H, Tada H. Cryoballoon left atrial roof ablation for persistent atrial fibrillation ∼Analysis with high-resolution mapping system∼. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2021; 45:589-597. [PMID: 34427933 DOI: 10.1111/pace.14345] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/12/2021] [Accepted: 08/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Additional benefit of cryoballoon left atrial roof line ablation (CB-RA) beyond cryoballoon pulmonary vein isolation (CB-PVI) is suggested in patients with persistent atrial fibrillation (PsAF). We sought to investigate the feasibility of CB-RA for PsAF and to determine the ablation area. METHODS AND RESULTS Fifty-three PsAF patients (67[58.5-75.5] years, 36 men, 11 longstanding PsAF) underwent CB-PVI. Subsequently, 44(83.0%) out of 53 patients underwent additional CB-RA. Voltage maps were created in all patients with a high-resolution mapping system. The total number and duration of CB-RAs were 3.9±0.7 and 468±84 seconds. LA roof areas were complete low voltage areas (LVAs) /scar in 37/44(84.1%) patients ("complete roof modification"). The normal LA posterior wall (LAPW) voltage area was 6.1(4.1-8.4)cm2, and the %LAPW isolation area was 61.0(47.2-71.7)%. The %LAPW isolation area was significantly greater in CB-RA patients than those without (64.0[54.2-73.2] vs. 45.0[39.5-50.5]%, p = 0.041) despite significantly larger LAs in the former group. The %LAPW isolation area was significantly greater in patients with transverse LA diameters <45 mm than those ≥45 mm (p<0.0001). The single procedure 1-year AF freedom was 87.4% (22.5% on antiarrhythmic drug) and tended to be higher in CB-RA patients than those without. Among the 44 CB-RA patients, it was significantly higher in patients with a complete roof modification than those without (94.4% vs. 75.0%, p = 0.0049). One CB-RA patient experienced a delayed cardiac tamponade requiring drainage at 4-months post-procedure. CONCLUSIONS CB-RA significantly expanded the LAPW isolation area, and a complete roof modification resulted in a high arrhythmia freedom in PsAF patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kanae Hasegawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Moe Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Daisetsu Aoyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Aryana A, Su W, Kuniss M, Okishige K, de Asmundis C, Tondo C, Chierchia GB. Segmental nonocclusive cryoballoon ablation of pulmonary veins and extrapulmonary vein structures: Best practices III. Heart Rhythm 2021; 18:1435-1444. [PMID: 33905811 DOI: 10.1016/j.hrthm.2021.04.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/18/2021] [Accepted: 04/20/2021] [Indexed: 11/19/2022]
Abstract
Although cryoballoon ablation of atrial fibrillation (AF) traditionally has been guided by pulmonary vein (PV) occlusion, there is evidence and growing interest in performing segmental, nonocclusive cryoballoon ablation to target not only large/common PVs but extra-PV structures such as the left atrial (LA) roof and posterior wall in conjunction with PV isolation. A number of studies have demonstrated improved clinical efficacy associated with nonocclusive cryoballoon ablation of the LA roof and posterior wall in addition to PV isolation, particularly in patients with persistent AF. Not only can the cryoballoon be used for targeting extra-PV structures through segmental, nonocclusive ablation, but the large size and durability of cryolesions coupled with the enhanced stability afforded through cryoadhesion render the cryoballoon an effective tool for such an approach. This article reviews the rationale and practical approach to segmental, nonocclusive cryoballoon ablation of large/common PV antra and the LA roof and posterior wall.
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Affiliation(s)
- Arash Aryana
- Mercy General Hospital and Dignity Health Heart and Vascular Institute, Sacramento, California.
| | - Wilber Su
- Banner University Medical Center, Phoenix, Arizona
| | - Malte Kuniss
- Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany
| | - Kaoru Okishige
- Heart Center, Japan Red Cross Yokohama City Bay Hospital, Yokohama, Japan
| | | | - Claudio Tondo
- Heart Rhythm Center, Centro Cardiologico Monzino IRCCS; Department of Biochemical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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16
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Cryoballoon ablation for extrapulmonary vein targets. Curr Opin Cardiol 2021; 36:22-25. [PMID: 33027099 DOI: 10.1097/hco.0000000000000802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Cryoballoon catheter can create large and contiguous lesions with stable contact during ablation. It has proven to be well tolerated and effective in pulmonary vein isolation. But atrial arrhythmias, including atrial fibrillation, atrial tachycardia, and atrial flutter (AFL), also relate to many extrapulmonary vein targets. It is necessary to understand the current evidence for the use of cryoballoon ablation for targets outside of pulmonary veins. RECENT FINDINGS Studies have shown that the cryoballoon ablation can be used in extrapulmonary vein area, including left atrium roof, left atrial appendages, posterior left atrial wall, mitral isthmus, and right atrial appendage. The results indicate cryoballoon ablation is an effective and well-tolerated treatment option for the atrial arrhythmias in these locations outside of pulmonary vein when clinical necessary. SUMMARY The cryoballoon ablation can safely and effectively perform contiguous linear lesions, structure isolations, and local ablation for targets outside of the pulmonary veins.
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17
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Zylla MM, Hochadel M, Andresen D, Brachmann J, Eckardt L, Hoffmann E, Kuck KH, Lewalter T, Schumacher B, Spitzer SG, Willems S, Senges J, Katus HA, Thomas D. Ablation of Atrial Fibrillation in Patients with Hypertension-An Analysis from the German Ablation Registry. J Clin Med 2020; 9:jcm9082402. [PMID: 32727136 PMCID: PMC7463680 DOI: 10.3390/jcm9082402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Hypertension (HTN) constitutes a risk factor for the development of atrial fibrillation (AF), as well as for thromboembolic and bleeding events. We analysed the outcome after catheter ablation of AF in HTN in a cohort from the prospective multicenter German Ablation Registry. Methods: Between 03/2008 and 01/2010, 626 patients undergoing AF-ablation were analysed. Patients diagnosed with HTN (n = 386) were compared with patients without HTN (n = 240) with respect to baseline, procedural and long-term outcome parameters. Results: Patients with HTN were older and more often presented with persistent forms of AF and cardiac comorbidities. Major and moderate in-hospital complications were low. At long-term follow-up, major cardiovascular events were rare in both groups. Rates of AF-recurrence, freedom from antiarrhythmic medication and repeat ablation were not statistically different between groups. Most patients reported improvement of symptoms and satisfaction with the treatment. However, patients with HTN more frequently complained of dyspnea of New York Heart Association (NYHA) class ≥ II and angina. They were more often rehospitalized, particularly when persistent AF had been diagnosed. Conclusion: Catheter ablation of AF is associated with low complication rates and favorable arrhythmia-related results in patients with HTN. Residual clinical symptoms may be due to cardiac comorbidities and require additional attention in this important subgroup of AF-patients.
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Affiliation(s)
- Maura M. Zylla
- Department of Cardiology, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany; (M.M.Z.); (H.A.K.)
- HCR (Heidelberg Center for Heart Rhythm Disorders), Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Medical University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Matthias Hochadel
- Stiftung Institut für Herzinfarktforschung, IHF, Bremserstraße 79, 67063 Ludwigshafen, Germany; (M.H.); (J.S.)
| | - Dietrich Andresen
- Department of Cardiology, Vivantes Hospital, Klinikum am Urban, Dieffenbachstraße 1, 10967 Berlin, Germany;
| | - Johannes Brachmann
- Department of Cardiology, Hospital Coburg, Ketschendorfer Str. 33, 96450 Coburg, Germany;
| | - Lars Eckardt
- Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany;
| | - Ellen Hoffmann
- Department of Cardiology/Intensive Care Medicine, Heart Center Munich-Bogenhausen, Englschalkinger Str. 77, 81925 Munich, Germany;
| | - Karl-Heinz Kuck
- Department of Cardiology, Asklepios Hospital St. Georg, Lohmühlenstraße 5, 20099 Hamburg, Germany;
| | - Thorsten Lewalter
- Klinik für Kardiologie und Internist, Intensivmedizin, Peter Osypka Herzzentrum, Internistisches Klinikum München Süd, Am Isarkanal 36, 81379 Munich, Germany;
| | - Burghard Schumacher
- Department of Cardiology, Herz- und Gefäßklinik, Salzburger Leite 1, 97616 Bad Neustadt/Saale, Germany;
| | - Stefan G. Spitzer
- Praxisklinik Herz und Gefäße, Forststraße 3, 01099 Dresden, Germany;
- Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Universitätsplatz 1, 01968 Senftenberg, Germany
| | - Stephan Willems
- Department of Cardiology/Electrophysiology, University Heart Center, Martinistraße 52, 20251 Hamburg, Germany;
| | - Jochen Senges
- Stiftung Institut für Herzinfarktforschung, IHF, Bremserstraße 79, 67063 Ludwigshafen, Germany; (M.H.); (J.S.)
| | - Hugo A. Katus
- Department of Cardiology, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany; (M.M.Z.); (H.A.K.)
- HCR (Heidelberg Center for Heart Rhythm Disorders), Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Medical University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Dierk Thomas
- Department of Cardiology, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany; (M.M.Z.); (H.A.K.)
- HCR (Heidelberg Center for Heart Rhythm Disorders), Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Medical University Hospital Heidelberg, 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-6221-568855; Fax: +49-6221-565514
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18
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Rahm AK, Lugenbiel P, Ochs M, Meder B, Thomas D, Katus HA, Scholz E. Pulmonary vein isolation treats symptomatic AF in a patient with Lamin A/C mutation: case report and review of the literature. Clin Res Cardiol 2020; 109:1070-1075. [PMID: 32144494 PMCID: PMC7376080 DOI: 10.1007/s00392-020-01616-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 01/31/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Ann-Kathrin Rahm
- Department of Cardiology, Medical University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.,Heidelberg Center for Heart Rhythm Disorders, Heidelberg, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Patrick Lugenbiel
- Department of Cardiology, Medical University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.,Heidelberg Center for Heart Rhythm Disorders, Heidelberg, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Marco Ochs
- Department of Cardiology, Medical University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Benjamin Meder
- Department of Cardiology, Medical University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Dierk Thomas
- Department of Cardiology, Medical University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.,Heidelberg Center for Heart Rhythm Disorders, Heidelberg, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Hugo A Katus
- Department of Cardiology, Medical University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.,Heidelberg Center for Heart Rhythm Disorders, Heidelberg, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Eberhard Scholz
- Department of Cardiology, Medical University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. .,Heidelberg Center for Heart Rhythm Disorders, Heidelberg, Germany. .,DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany.
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