Initial experience of three-minute freeze cycles using the second-generation cryoballoon ablation: acute and short-term procedural outcomes

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• 作者：Gian-Battista Chierchia (1)
  Giacomo Di Giovanni (1)
  Juan Sieira-Moret (1)
  Carlo de Asmundis (1)
  Giulio Conte (1)
  Moises Rodriguez-Ma?ero (1)
  Ruben Casado-Arroyo (1)
  Giannis Baltogiannis (1)
  Gaetano Paparella (2)
  Giuseppe Ciconte (1)
  Andrea Sarkozy (1)
  Pedro Brugada (1)
  
• 关键词：Cryoballoon ; Atrial fibrillation ; Ablation ; Pulmonary vein isolation ; Freeze duration
• 刊名：Journal of Interventional Cardiac Electrophysiology
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：39
• 期：2
• 页码：145-151
• 全文大小：169 KB
• 参考文献：1. Fürnkranz, A., Bordignon, S., Schmidt, B., et al. (2013). Improved procedural efficacy of pulmonary vein isolation using the novel second-generation cryoballoon. / Journal of Cardiovascular Electrophysiology, 24(5), 492-97. CrossRef
  2. Andrade, J. G., Dubuc, M., Guerra, P. G., et al. (2013). Pulmonary vein isolation using a second-generation cryoballoon catheter: a randomized comparison of ablation duration and method of deflation. / Journal of Cardiovascular Electrophysiology, 24(6), 692-98. CrossRef
  3. Coulombe, N., Paulin, J., & Su, W. (2013). Improved in vivo performance of second-generation cryoballoon for pulmonary vein isolation. / J Cardiovasc Electrophysiol, 24(8), 919-5. doi:10.1111/jce.12157 . CrossRef
  4. Dubuc, M., Roy, D., Thibault, B., et al. (1999). Transvenous catheter ice mapping and cryoablation of the atrioventricular node in dogs. / Pacing and Clinical Electrophysiology, 22(10), 1488-498. CrossRef
  5. Chierchia, G. B., Namdar, M., Sarkozy, A., et al. (2012). Verification of pulmonary vein isolation during single transseptal cryoballoon ablation: a comparison between the classical circular mapping catheter and the inner lumen mapping catheter. / Europace, 14(12), 1708-714. CrossRef
  6. Neumann, T., Vogt, J., Schumacher, B., Dorszewski, A., Kuniss, M., Neuser, H., et al. (2008). Circumferential pulmonary vein isolation with the cryoballoon technique results from a prospective 3-center study. / Journal of the American College of Cardiology, 52, 273-78. CrossRef
  7. Chun, K. R., Schmidt, B., Metzner, A., Tilz, R., Zerm, T., K?ster, I., et al. (2009). The ‘single big cryoballoon-technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study. / European Heart Journal, 30(6), 699-09. CrossRef
  8. Metzner, A., Burchard, A., Wohlmuth, P., Rausch, P., Bardyszewski, A., Gienapp, C., Tilz, R. R., Rillig, A., Mathew, S., Deiss, S., Makimoto, H., Ouyang, F., Kuck, K. H., & Wissner, E. (2013). Increased incidence of esophageal thermal lesions using the second-generation 28 mm cryoballoon. / Circ Arrhythm Electrophysiol. doi:10.1161/CIRCEP.113.000228 .
  9. Kühne, M., Knecht, S., Altmann, D., et al. (2013). Validation of a novel spiral mapping catheter for real-time recordings from the pulmonary veins during cryoballoon ablation of atrial fibrillation. / Heart Rhythm, 10(2), 241-46. CrossRef
  10. Ghosh, J., Sepahpour, A., Chan, K. H., Singarayar, S., & McGuire, M. A. (2013). Immediate balloon deflation for prevention of persistent phrenic nerve palsy during pulmonary vein isolation by balloon cryoablation. / Heart Rhythm, 10(5), 646-52. CrossRef
  11. Kühne, M., Knecht, S., Altmann, D., et al. (2013). Phrenic nerve palsy during ablation of atrial fibrillation using a 28-mm cryoballoon catheter: predictors and prevention. / Journal of Interventional Cardiac Electrophysiology, 36(1), 47-4. CrossRef
  12. Franceschi, F., Dubuc, M., Guerra, P. G., & Khairy, P. (2011). Phrenic nerve monitoring with diaphragmatic electromyography during cryoballoon ablation for atrial fibrillation: the first human application. / Heart Rhythm, 8(7), 1068-071. CrossRef
  13. Franceschi, F., Dubuc, M., Guerra, P. G., et al. (2011). Diaphragmatic electromyography during cryoballoon ablation: a novel concept in the prevention of phrenic nerve palsy. / Heart Rhythm, 8(6), 885-91. CrossRef
  14. Fürnkranz, A., Bordignon, S., Schmidt, B., B?hmig, M., B?hmer, M. C., Bode, F., et al. (2013). Luminal esophageal temperature predicts esophageal lesions after second-generation cryoballoon pulmonary vein isolation. / Heart Rhythm, 10(6), 789-93. CrossRef
  15. Neumann, T., Wójcik, M., Berkowitsch, A., et al. (2013). Cryoballoon ablation of paroxysmal atrial fibrillation: 5-year outcome after single procedure and predictors of success. / Europace, 15(8), 1143-. doi:10.1093/europace/eut021 . CrossRef
  16. Rao, J.Y., Chierchia, G.B., de Asmundis, C., et al. (2013). Cryoballoon ablation as index procedure for paroxysmal atrial fibrillation: long-term results from a single center early experience. / J Cardiovasc Med (Hagerstown). 2013 Jun 10. doi:10.2459/JCM.0b013e3283623838 .
  17. Vogt, J., Heintze, J., Gutleben, K. J., Muntean, B., Horstkotte, D., & N?lker, G. (2013). Long-term outcomes after cryoballoon pulmonary vein isolation: results from a prospective study in 605 patients. / Journal of the American College of Cardiology, 61(16), 1707-712. CrossRef
  18. Klein, G., Oswald, H., Gardiwal, A., et al. (2008). Efficacy of pulmonary vein isolation by cryoballoon ablation in patients with paroxysmal atrial fibrillation. / Heart Rhythm, 5(6), 802-06. CrossRef
  19. Chierchia, G. B., de Asmundis, C., Müller-Burri, S. A., et al. (2009). Early recovery of pulmonary vein conduction after cryoballoon ablation for paroxysmal atrial fibrillation: a prospective study. / Europace, 11(4), 445-49. CrossRef
  
• 作者单位：Gian-Battista Chierchia (1)
  Giacomo Di Giovanni (1)
  Juan Sieira-Moret (1)
  Carlo de Asmundis (1)
  Giulio Conte (1)
  Moises Rodriguez-Ma?ero (1)
  Ruben Casado-Arroyo (1)
  Giannis Baltogiannis (1)
  Gaetano Paparella (2)
  Giuseppe Ciconte (1)
  Andrea Sarkozy (1)
  Pedro Brugada (1)
  
  1. Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, 1090, Brussels, Belgium
  2. Cardiology Department, Cliniques St Jean, Brussels, Belgium
  
• ISSN：1572-8595

文摘

Background The second-generation cryoballoon (CB-A) (Arctic Front Advance, Cryocath, Medtronic, MN, USA) might significantly improve procedural outcome with respect to the first-generation balloon. These technological improvements might also question the current recommendation of the need a 4-min freeze to achieve durable pulmonary vein isolation (PVI). Objective The main aim of the study was to analyze the procedural efficacy of a 3-min freeze–thaw cycles with the CB-A balloon in the terms of rates of acute PVI and 6-month outcome. Methods Patients having undergone CB-A for PAF or early persistent AF, with 3-min freeze–thaw cycles were consecutively included in our analysis. Acute procedural success was measured in terms of the rate of PVI. Short-term follow-up was evaluated by the means of 24-h Holters and clinical examinations at regular intervals. Results Fifty-two consecutive patients (35 male (67?%); mean age, 59.8?±-0.5) were included. Mean procedure and fluoroscopy times were 96?±-5 and 13.2?±-.3?min, respectively. Mean time from groin puncture to catheter extraction was 60.4?±-0?min. After a mean of 1.5 freeze cycles per vein of 3?min in duration, all 208 (100?%) PVs could be isolated with the CB-A. A total 192 (91?%) veins were isolated during the first freeze. At a mean of 5.7-month follow-up, 82?% of patients were free of AF. Conclusion CB-A is effective in producing PVI by using 3-min-duration freeze cycles. After a mean of 1.5 freeze per vein, freedom from AF was achieved in 82?% of patients at 6-month follow-up.