Initial experience and procedural efficacy of pulmonary vein isolation using the fourth-generation cryoballoon - a step forward?
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Initial experience and procedural efficacy of pulmonary vein isolation using the fourth-generation cryoballoon - a step forward? / Mathew, Shibu; Rottner, Laura; Warneke, Laura; Maurer, Tilman; Lemes, Christine; Hashiguchi, Naotaka; Reißmann, Bruno; Goldmann, Britta; Ouyang, Feifan; Kuck, Karl-Heinz; Metzner, Andreas; Rillig, Andreas.
in: ACTA CARDIOL, Jahrgang 75, Nr. 8, 12.2020, S. 754-759.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Initial experience and procedural efficacy of pulmonary vein isolation using the fourth-generation cryoballoon - a step forward?
AU - Mathew, Shibu
AU - Rottner, Laura
AU - Warneke, Laura
AU - Maurer, Tilman
AU - Lemes, Christine
AU - Hashiguchi, Naotaka
AU - Reißmann, Bruno
AU - Goldmann, Britta
AU - Ouyang, Feifan
AU - Kuck, Karl-Heinz
AU - Metzner, Andreas
AU - Rillig, Andreas
PY - 2020/12
Y1 - 2020/12
N2 - Background: Cryoballoon (CB)-based pulmonary vein isolation (PVI) is an established treatment modality for patients suffering from paroxysmal or persistent atrial fibrillation (AF). Recently, the novel fourth-generation cryoballoon (CB4) was introduced which mainly provides a 40% shorter distal tip as compared to the second-generation cryoballoon (CB2). This two-centre analysis sought to assess the primary efficacy of the 28 mm CB4 for PVI and the feasibility of real-time signal recordings from the PVs considering the time-to-isolation (TTI).Methods and results: Eighty-four patients with paroxysmal or short-standing persistent AF underwent CB4-based PVI at two different hospitals. Individual freeze-cycle duration was set at TTI + 120 seconds. No bonus freeze was applied. A total of 331 pulmonary veins (PVs) including five left common PVs were identified and all PVs were successfully isolated. Mean freeze-cycle duration was 165.7 ± 31.5 seconds. The mean minimal CB temperature was -45.6 ± 7.6 °C with a real-time PVI visualisation rate of 78% (67/84 (79.8%) RSPVs, 55/84 (65.5%) RIPVs, 67/79 (84.8%) LSPVs, 66/79 (83.5%) LIPVs and 2/5 (40%) LCPV). Transient phrenic nerve palsy occurred in 2/84 (2.4%) patients during cryo-application along the RSPV.Conclusions: The novel CB4 provides both, a high acute efficacy and a high rate of real time electrical PV-recordings, thus facilitating individual ablation strategies based on TTI.
AB - Background: Cryoballoon (CB)-based pulmonary vein isolation (PVI) is an established treatment modality for patients suffering from paroxysmal or persistent atrial fibrillation (AF). Recently, the novel fourth-generation cryoballoon (CB4) was introduced which mainly provides a 40% shorter distal tip as compared to the second-generation cryoballoon (CB2). This two-centre analysis sought to assess the primary efficacy of the 28 mm CB4 for PVI and the feasibility of real-time signal recordings from the PVs considering the time-to-isolation (TTI).Methods and results: Eighty-four patients with paroxysmal or short-standing persistent AF underwent CB4-based PVI at two different hospitals. Individual freeze-cycle duration was set at TTI + 120 seconds. No bonus freeze was applied. A total of 331 pulmonary veins (PVs) including five left common PVs were identified and all PVs were successfully isolated. Mean freeze-cycle duration was 165.7 ± 31.5 seconds. The mean minimal CB temperature was -45.6 ± 7.6 °C with a real-time PVI visualisation rate of 78% (67/84 (79.8%) RSPVs, 55/84 (65.5%) RIPVs, 67/79 (84.8%) LSPVs, 66/79 (83.5%) LIPVs and 2/5 (40%) LCPV). Transient phrenic nerve palsy occurred in 2/84 (2.4%) patients during cryo-application along the RSPV.Conclusions: The novel CB4 provides both, a high acute efficacy and a high rate of real time electrical PV-recordings, thus facilitating individual ablation strategies based on TTI.
KW - Atrial Fibrillation/physiopathology
KW - Cardiac Catheters
KW - Cryosurgery/instrumentation
KW - Equipment Design
KW - Female
KW - Heart Rate/physiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Operative Time
KW - Pulmonary Veins/surgery
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1080/00015385.2019.1677373
DO - 10.1080/00015385.2019.1677373
M3 - SCORING: Journal article
C2 - 31630633
VL - 75
SP - 754
EP - 759
JO - ACTA CARDIOL
JF - ACTA CARDIOL
SN - 0001-5385
IS - 8
ER -