Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation
International audience BACKGROUND: Compared with the first-generation Arctic Front cryoballoon (ARC-CB), the new Arctic Front Advance cryoballoon (ARC-Adv-CB) increases the efficient CB-tissue contact surface during freezing, which may increase the incidence of phrenic nerve (PN) palsy (PNP). OBJECT...
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ftinserm:oai:HAL:hal-03233143v1 2024-09-15T18:11:07+00:00 Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation Martins, Raphaël Hamon, David Césari, Olivier Behaghel, Albin Behar, Nathalie Sellal, Jean-Marc Daubert, Jean-Claude Mabo, Philippe Pavin, Dominique Service de cardiologie et maladies vasculaires Rennes = Cardiac, Thoracic, and Vascular Surgery Rennes Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Pontchaillou Laboratoire Traitement du Signal et de l'Image (LTSI) Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM) CIC-IT Rennes Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Pontchaillou -Institut National de la Santé et de la Recherche Médicale (INSERM) Clinique Saint Gatien 2014-03 https://hal.univ-lorraine.fr/hal-03233143 https://doi.org/10.1016/j.hrthm.2014.01.002 en eng HAL CCSD Elsevier info:eu-repo/semantics/altIdentifier/doi/10.1016/j.hrthm.2014.01.002 info:eu-repo/semantics/altIdentifier/pmid/24389575 hal-03233143 https://hal.univ-lorraine.fr/hal-03233143 doi:10.1016/j.hrthm.2014.01.002 PUBMED: 24389575 ISSN: 1556-3871 EISSN: 1547-5271 Heart Rhythm https://hal.univ-lorraine.fr/hal-03233143 Heart Rhythm, 2014, 11 (3), pp.386-393. ⟨10.1016/j.hrthm.2014.01.002⟩ Cryoablation Paroxysmal atrial fibrillation Cryoballoon ablation Pulmonary vein Pulmonary vein isolation Phrenic nerve palsy [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology info:eu-repo/semantics/article Journal articles 2014 ftinserm https://doi.org/10.1016/j.hrthm.2014.01.002 2024-07-22T23:41:41Z International audience BACKGROUND: Compared with the first-generation Arctic Front cryoballoon (ARC-CB), the new Arctic Front Advance cryoballoon (ARC-Adv-CB) increases the efficient CB-tissue contact surface during freezing, which may increase the incidence of phrenic nerve (PN) palsy (PNP). OBJECTIVE: To evaluate the safety and efficacy of paroxysmal atrial fibrillation (AF) ablation with the ARC-Adv-CB as well as the merits of a predictor of PNP. METHODS: AF ablation was performed by using a "single 28-mm big CB" approach. The rate of pulmonary vein (PV) isolation with a first cryoapplication was measured. The distance between the CB and a PN pacing catheter in the superior vena cava was measured to predict PNP during freezing. RESULTS: In 147 patients, PV were isolated with a single cryoapplication in 205 (81.3%) of 252 PV treated with the ARC-CB and in 280 (90.3%) of 310 PV treated with the ARC-Adv-CB (P = .003). The mean time to PV isolation was 52 ± 34 seconds and 40 ± 25 seconds (P < .001) and the temperature at the time of isolation was -36.1 ± 10.3°C and -32.3 ± 10.2°C (P = .001) in the ARC-CB and ARC-Adv-CB groups, respectively. Mean procedure and fluoroscopy durations were significantly shorter in the ARC-Adv-CB group. Transient PNP was observed in 7(10.6%) and 20(24.4%) of the patients treated with the ARC-CB and ARC-Adv-CB, respectively (P = .048). The distance between the lateral edge of the CB and a vertical line through the tip of the pacing catheter accurately predicted PNP (P < .001). CONCLUSIONS: The 28-mm ARC-Adv-CB enabled more efficient ablation of paroxysmal AF and shorter procedures than did the ARC-CB. This higher performance was associated with a higher incidence of PNP, which was predicted by the distance between the CB and the PN. Article in Journal/Newspaper Human health Inserm: HAL (Institut national de la santé et de la recherche médicale) Heart Rhythm 11 3 386 393 |
institution |
Open Polar |
collection |
Inserm: HAL (Institut national de la santé et de la recherche médicale) |
op_collection_id |
ftinserm |
language |
English |
topic |
Cryoablation Paroxysmal atrial fibrillation Cryoballoon ablation Pulmonary vein Pulmonary vein isolation Phrenic nerve palsy [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
spellingShingle |
Cryoablation Paroxysmal atrial fibrillation Cryoballoon ablation Pulmonary vein Pulmonary vein isolation Phrenic nerve palsy [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology Martins, Raphaël Hamon, David Césari, Olivier Behaghel, Albin Behar, Nathalie Sellal, Jean-Marc Daubert, Jean-Claude Mabo, Philippe Pavin, Dominique Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation |
topic_facet |
Cryoablation Paroxysmal atrial fibrillation Cryoballoon ablation Pulmonary vein Pulmonary vein isolation Phrenic nerve palsy [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
description |
International audience BACKGROUND: Compared with the first-generation Arctic Front cryoballoon (ARC-CB), the new Arctic Front Advance cryoballoon (ARC-Adv-CB) increases the efficient CB-tissue contact surface during freezing, which may increase the incidence of phrenic nerve (PN) palsy (PNP). OBJECTIVE: To evaluate the safety and efficacy of paroxysmal atrial fibrillation (AF) ablation with the ARC-Adv-CB as well as the merits of a predictor of PNP. METHODS: AF ablation was performed by using a "single 28-mm big CB" approach. The rate of pulmonary vein (PV) isolation with a first cryoapplication was measured. The distance between the CB and a PN pacing catheter in the superior vena cava was measured to predict PNP during freezing. RESULTS: In 147 patients, PV were isolated with a single cryoapplication in 205 (81.3%) of 252 PV treated with the ARC-CB and in 280 (90.3%) of 310 PV treated with the ARC-Adv-CB (P = .003). The mean time to PV isolation was 52 ± 34 seconds and 40 ± 25 seconds (P < .001) and the temperature at the time of isolation was -36.1 ± 10.3°C and -32.3 ± 10.2°C (P = .001) in the ARC-CB and ARC-Adv-CB groups, respectively. Mean procedure and fluoroscopy durations were significantly shorter in the ARC-Adv-CB group. Transient PNP was observed in 7(10.6%) and 20(24.4%) of the patients treated with the ARC-CB and ARC-Adv-CB, respectively (P = .048). The distance between the lateral edge of the CB and a vertical line through the tip of the pacing catheter accurately predicted PNP (P < .001). CONCLUSIONS: The 28-mm ARC-Adv-CB enabled more efficient ablation of paroxysmal AF and shorter procedures than did the ARC-CB. This higher performance was associated with a higher incidence of PNP, which was predicted by the distance between the CB and the PN. |
author2 |
Service de cardiologie et maladies vasculaires Rennes = Cardiac, Thoracic, and Vascular Surgery Rennes Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Pontchaillou Laboratoire Traitement du Signal et de l'Image (LTSI) Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM) CIC-IT Rennes Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Pontchaillou -Institut National de la Santé et de la Recherche Médicale (INSERM) Clinique Saint Gatien |
format |
Article in Journal/Newspaper |
author |
Martins, Raphaël Hamon, David Césari, Olivier Behaghel, Albin Behar, Nathalie Sellal, Jean-Marc Daubert, Jean-Claude Mabo, Philippe Pavin, Dominique |
author_facet |
Martins, Raphaël Hamon, David Césari, Olivier Behaghel, Albin Behar, Nathalie Sellal, Jean-Marc Daubert, Jean-Claude Mabo, Philippe Pavin, Dominique |
author_sort |
Martins, Raphaël |
title |
Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation |
title_short |
Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation |
title_full |
Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation |
title_fullStr |
Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation |
title_full_unstemmed |
Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation |
title_sort |
safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation |
publisher |
HAL CCSD |
publishDate |
2014 |
url |
https://hal.univ-lorraine.fr/hal-03233143 https://doi.org/10.1016/j.hrthm.2014.01.002 |
genre |
Human health |
genre_facet |
Human health |
op_source |
ISSN: 1556-3871 EISSN: 1547-5271 Heart Rhythm https://hal.univ-lorraine.fr/hal-03233143 Heart Rhythm, 2014, 11 (3), pp.386-393. ⟨10.1016/j.hrthm.2014.01.002⟩ |
op_relation |
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.hrthm.2014.01.002 info:eu-repo/semantics/altIdentifier/pmid/24389575 hal-03233143 https://hal.univ-lorraine.fr/hal-03233143 doi:10.1016/j.hrthm.2014.01.002 PUBMED: 24389575 |
op_doi |
https://doi.org/10.1016/j.hrthm.2014.01.002 |
container_title |
Heart Rhythm |
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11 |
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3 |
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386 |
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