The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study
Aims Cryothermal energy (CTE) ablation via a balloon catheter (Arctic Front, Cryocath™) represents a novel technology for pulmonary vein isolation (PVI). However, balloon-based PVI approaches are associated with phrenic nerve palsy (PNP). We investigated whether ‘single big cryoballoon’-deployed CTE...
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2009
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fthighwire:oai:open-archive.highwire.org:ehj:30/6/699 2023-05-15T15:11:40+02:00 The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study Chun, Kyoung-Ryul Julian Schmidt, Boris Metzner, Andreas Tilz, Roland Zerm, Thomas Köster, Ilka Fürnkranz, Alexander Koektuerk, Buelent Konstantinidou, Melanie Antz, Matthias Ouyang, Feifan Kuck, Karl Heinz 2009-03-02 00:00:00.0 text/html http://eurheartj.oxfordjournals.org/cgi/content/short/30/6/699 https://doi.org/10.1093/eurheartj/ehn570 en eng Oxford University Press http://eurheartj.oxfordjournals.org/cgi/content/short/30/6/699 http://dx.doi.org/10.1093/eurheartj/ehn570 Copyright (C) 2009, European Society of Cardiology Arrhythmia TEXT 2009 fthighwire https://doi.org/10.1093/eurheartj/ehn570 2013-05-27T14:29:59Z Aims Cryothermal energy (CTE) ablation via a balloon catheter (Arctic Front, Cryocath™) represents a novel technology for pulmonary vein isolation (PVI). However, balloon-based PVI approaches are associated with phrenic nerve palsy (PNP). We investigated whether ‘single big cryoballoon’-deployed CTE lesions can (i) achieve acute electrical PVI without left atrium (LA) imaging and (ii) avoid PNP in patients with paroxysmal atrial fibrillation (PAF). Methods and results After double transseptal punctures, one Lasso catheter and a big 28 mm cryoballoon catheter using a steerable sheath were inserted into the LA. PV angiography and ostial Lasso recordings from all PVs were obtained. Selective PV angiography was used to evaluate balloon to LA–PV junction contact. CTE ablation lasted 300 s, and the PN was paced during freezing at right-sided PVs. Twenty-seven patients (19 males, mean age: 56 ± 9 years, LA size: 42 ± 5 mm) with PAF (mean duration: 6.6 ± 5.7 years) were included. PVI was achieved in 97/99 PVs (98%). Median ( Q 1 Q 3 ) procedural, balloon, and fluoroscopy times were 220 min (190; 245), 130 min (90; 170), and 50 min (42; 69), respectively. Three transient PNP occurred after distal PV ablations. No PV stenosis occurred. Total median ( Q 1 Q 3 ) follow-up time was 271 days (147; 356), and 19 of 27 patients (70%) remained in sinus rhythm (3-month blanking period). Conclusion Using the single big cryoballoon technique, almost all PVs (98%) could be electrically isolated without LA imaging and may reduce the incidence of PNP as long as distal ablation inside the septal PVs is avoided. Text Arctic HighWire Press (Stanford University) Arctic European Heart Journal 30 6 699 709 |
institution |
Open Polar |
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HighWire Press (Stanford University) |
op_collection_id |
fthighwire |
language |
English |
topic |
Arrhythmia |
spellingShingle |
Arrhythmia Chun, Kyoung-Ryul Julian Schmidt, Boris Metzner, Andreas Tilz, Roland Zerm, Thomas Köster, Ilka Fürnkranz, Alexander Koektuerk, Buelent Konstantinidou, Melanie Antz, Matthias Ouyang, Feifan Kuck, Karl Heinz The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study |
topic_facet |
Arrhythmia |
description |
Aims Cryothermal energy (CTE) ablation via a balloon catheter (Arctic Front, Cryocath™) represents a novel technology for pulmonary vein isolation (PVI). However, balloon-based PVI approaches are associated with phrenic nerve palsy (PNP). We investigated whether ‘single big cryoballoon’-deployed CTE lesions can (i) achieve acute electrical PVI without left atrium (LA) imaging and (ii) avoid PNP in patients with paroxysmal atrial fibrillation (PAF). Methods and results After double transseptal punctures, one Lasso catheter and a big 28 mm cryoballoon catheter using a steerable sheath were inserted into the LA. PV angiography and ostial Lasso recordings from all PVs were obtained. Selective PV angiography was used to evaluate balloon to LA–PV junction contact. CTE ablation lasted 300 s, and the PN was paced during freezing at right-sided PVs. Twenty-seven patients (19 males, mean age: 56 ± 9 years, LA size: 42 ± 5 mm) with PAF (mean duration: 6.6 ± 5.7 years) were included. PVI was achieved in 97/99 PVs (98%). Median ( Q 1 Q 3 ) procedural, balloon, and fluoroscopy times were 220 min (190; 245), 130 min (90; 170), and 50 min (42; 69), respectively. Three transient PNP occurred after distal PV ablations. No PV stenosis occurred. Total median ( Q 1 Q 3 ) follow-up time was 271 days (147; 356), and 19 of 27 patients (70%) remained in sinus rhythm (3-month blanking period). Conclusion Using the single big cryoballoon technique, almost all PVs (98%) could be electrically isolated without LA imaging and may reduce the incidence of PNP as long as distal ablation inside the septal PVs is avoided. |
format |
Text |
author |
Chun, Kyoung-Ryul Julian Schmidt, Boris Metzner, Andreas Tilz, Roland Zerm, Thomas Köster, Ilka Fürnkranz, Alexander Koektuerk, Buelent Konstantinidou, Melanie Antz, Matthias Ouyang, Feifan Kuck, Karl Heinz |
author_facet |
Chun, Kyoung-Ryul Julian Schmidt, Boris Metzner, Andreas Tilz, Roland Zerm, Thomas Köster, Ilka Fürnkranz, Alexander Koektuerk, Buelent Konstantinidou, Melanie Antz, Matthias Ouyang, Feifan Kuck, Karl Heinz |
author_sort |
Chun, Kyoung-Ryul Julian |
title |
The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study |
title_short |
The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study |
title_full |
The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study |
title_fullStr |
The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study |
title_full_unstemmed |
The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study |
title_sort |
'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study |
publisher |
Oxford University Press |
publishDate |
2009 |
url |
http://eurheartj.oxfordjournals.org/cgi/content/short/30/6/699 https://doi.org/10.1093/eurheartj/ehn570 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_relation |
http://eurheartj.oxfordjournals.org/cgi/content/short/30/6/699 http://dx.doi.org/10.1093/eurheartj/ehn570 |
op_rights |
Copyright (C) 2009, European Society of Cardiology |
op_doi |
https://doi.org/10.1093/eurheartj/ehn570 |
container_title |
European Heart Journal |
container_volume |
30 |
container_issue |
6 |
container_start_page |
699 |
op_container_end_page |
709 |
_version_ |
1766342486283780096 |