Durability of Pulmonary Vein Isolation with Cryoballoon Ablation: Results from the Sustained PV Isolation with Arctic Front Advance (SUPIR) Study
Durability of Pulmonary Vein Isolation with Cryoballoon Ablation Introduction Pulmonary vein (PV) reconnection remains the most important cause of AF recurrence after AF ablation. The second‐generation cryoballoon catheter's ability to achieve durable PV isolation was assessed in a prospective...
Published in: | Journal of Cardiovascular Electrophysiology |
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Online Access: | http://dx.doi.org/10.1111/jce.12626 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fjce.12626 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.12626 |
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crwiley:10.1111/jce.12626 2024-09-09T19:27:21+00:00 Durability of Pulmonary Vein Isolation with Cryoballoon Ablation: Results from the Sustained PV Isolation with Arctic Front Advance (SUPIR) Study REDDY, VIVEK Y. SEDIVA, LUCIE PETRU, JAN SKODA, JAN CHOVANEC, MILAN CHITOVOVA, ZITA DI STEFANO, PAOLA RUBIN, ETHEL DUKKIPATI, SRINIVAS NEUZIL, PETR Medtronic International Trading Sarl 2015 http://dx.doi.org/10.1111/jce.12626 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fjce.12626 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.12626 en eng Wiley http://onlinelibrary.wiley.com/termsAndConditions#vor Journal of Cardiovascular Electrophysiology volume 26, issue 5, page 493-500 ISSN 1045-3873 1540-8167 journal-article 2015 crwiley https://doi.org/10.1111/jce.12626 2024-08-13T04:18:21Z Durability of Pulmonary Vein Isolation with Cryoballoon Ablation Introduction Pulmonary vein (PV) reconnection remains the most important cause of AF recurrence after AF ablation. The second‐generation cryoballoon catheter's ability to achieve durable PV isolation was assessed in a prospective nonrandomized clinical trial. Methods and Results PV isolation was performed by 4‐minute ablations. Following verification of electrical isolation by a multielectrode mapping catheter, 1 additional lesion per PV was applied. Esophageal temperatures were monitored and all patients underwent postprocedure esophageal endoscopy. All patients underwent a second PV remapping procedure at ∼3 months to assess for PVI durability. Eighty‐four (100%) veins were acutely isolated using only the 28 mm cryoballoon in 21 consecutive PAF patients with 2.2 ± 0.6 cryoapplications per vein, with the majority (83%) occurring after a single freeze. One patient presented with hematemesis and an esophageal ulceration that was treated conservatively; there were no episodes of esophageal fistula or phrenic nerve palsy. At 3.4 (2.9–4.1) months postablation, 68/75 veins (91%) remained electrically isolated; all PVs remained durably isolated in 79% of patients. Two patients accounted for 5 of 7 reconducting veins. The most common site for reconnection was the inferior aspect of the RIPV (3/7 reconnections). Reconnected veins had poorer occlusion at the index ablation procedure than veins that maintained chronic isolation (occlusion grade 2.9 ± 0.7 vs. 3.4 ± 0.7, P = 0.001). Clinical AF recurrence was detected in 2 patients (11%) at follow‐up. Conclusions The improved thermodynamic characteristics of the second‐generation cryoballoon led to a high rate of both single‐shot PVI and chronic lesion durability. This high rate of durable PV isolation is anticipated to translate to improved clinical outcome. Article in Journal/Newspaper Arctic Wiley Online Library Arctic Journal of Cardiovascular Electrophysiology 26 5 493 500 |
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Wiley Online Library |
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crwiley |
language |
English |
description |
Durability of Pulmonary Vein Isolation with Cryoballoon Ablation Introduction Pulmonary vein (PV) reconnection remains the most important cause of AF recurrence after AF ablation. The second‐generation cryoballoon catheter's ability to achieve durable PV isolation was assessed in a prospective nonrandomized clinical trial. Methods and Results PV isolation was performed by 4‐minute ablations. Following verification of electrical isolation by a multielectrode mapping catheter, 1 additional lesion per PV was applied. Esophageal temperatures were monitored and all patients underwent postprocedure esophageal endoscopy. All patients underwent a second PV remapping procedure at ∼3 months to assess for PVI durability. Eighty‐four (100%) veins were acutely isolated using only the 28 mm cryoballoon in 21 consecutive PAF patients with 2.2 ± 0.6 cryoapplications per vein, with the majority (83%) occurring after a single freeze. One patient presented with hematemesis and an esophageal ulceration that was treated conservatively; there were no episodes of esophageal fistula or phrenic nerve palsy. At 3.4 (2.9–4.1) months postablation, 68/75 veins (91%) remained electrically isolated; all PVs remained durably isolated in 79% of patients. Two patients accounted for 5 of 7 reconducting veins. The most common site for reconnection was the inferior aspect of the RIPV (3/7 reconnections). Reconnected veins had poorer occlusion at the index ablation procedure than veins that maintained chronic isolation (occlusion grade 2.9 ± 0.7 vs. 3.4 ± 0.7, P = 0.001). Clinical AF recurrence was detected in 2 patients (11%) at follow‐up. Conclusions The improved thermodynamic characteristics of the second‐generation cryoballoon led to a high rate of both single‐shot PVI and chronic lesion durability. This high rate of durable PV isolation is anticipated to translate to improved clinical outcome. |
author2 |
Medtronic International Trading Sarl |
format |
Article in Journal/Newspaper |
author |
REDDY, VIVEK Y. SEDIVA, LUCIE PETRU, JAN SKODA, JAN CHOVANEC, MILAN CHITOVOVA, ZITA DI STEFANO, PAOLA RUBIN, ETHEL DUKKIPATI, SRINIVAS NEUZIL, PETR |
spellingShingle |
REDDY, VIVEK Y. SEDIVA, LUCIE PETRU, JAN SKODA, JAN CHOVANEC, MILAN CHITOVOVA, ZITA DI STEFANO, PAOLA RUBIN, ETHEL DUKKIPATI, SRINIVAS NEUZIL, PETR Durability of Pulmonary Vein Isolation with Cryoballoon Ablation: Results from the Sustained PV Isolation with Arctic Front Advance (SUPIR) Study |
author_facet |
REDDY, VIVEK Y. SEDIVA, LUCIE PETRU, JAN SKODA, JAN CHOVANEC, MILAN CHITOVOVA, ZITA DI STEFANO, PAOLA RUBIN, ETHEL DUKKIPATI, SRINIVAS NEUZIL, PETR |
author_sort |
REDDY, VIVEK Y. |
title |
Durability of Pulmonary Vein Isolation with Cryoballoon Ablation: Results from the Sustained PV Isolation with Arctic Front Advance (SUPIR) Study |
title_short |
Durability of Pulmonary Vein Isolation with Cryoballoon Ablation: Results from the Sustained PV Isolation with Arctic Front Advance (SUPIR) Study |
title_full |
Durability of Pulmonary Vein Isolation with Cryoballoon Ablation: Results from the Sustained PV Isolation with Arctic Front Advance (SUPIR) Study |
title_fullStr |
Durability of Pulmonary Vein Isolation with Cryoballoon Ablation: Results from the Sustained PV Isolation with Arctic Front Advance (SUPIR) Study |
title_full_unstemmed |
Durability of Pulmonary Vein Isolation with Cryoballoon Ablation: Results from the Sustained PV Isolation with Arctic Front Advance (SUPIR) Study |
title_sort |
durability of pulmonary vein isolation with cryoballoon ablation: results from the sustained pv isolation with arctic front advance (supir) study |
publisher |
Wiley |
publishDate |
2015 |
url |
http://dx.doi.org/10.1111/jce.12626 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fjce.12626 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.12626 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Journal of Cardiovascular Electrophysiology volume 26, issue 5, page 493-500 ISSN 1045-3873 1540-8167 |
op_rights |
http://onlinelibrary.wiley.com/termsAndConditions#vor |
op_doi |
https://doi.org/10.1111/jce.12626 |
container_title |
Journal of Cardiovascular Electrophysiology |
container_volume |
26 |
container_issue |
5 |
container_start_page |
493 |
op_container_end_page |
500 |
_version_ |
1809896789228126208 |