Improved procedural efficacy of pulmonary vein isolation using the novel second-generation cryoballoon
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Improved procedural efficacy of pulmonary vein isolation using the novel second-generation cryoballoon. / Fürnkranz, Alexander; Bordignon, Stefano; Schmidt, Boris; Gunawardene, Melanie; Schulte-Hahn, Britta; Urban, Verena; Bode, Frank; Nowak, Bernd; Chun, Julian K R.
In: J CARDIOVASC ELECTR, Vol. 24, No. 5, 01.05.2013, p. 492-7.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Improved procedural efficacy of pulmonary vein isolation using the novel second-generation cryoballoon
AU - Fürnkranz, Alexander
AU - Bordignon, Stefano
AU - Schmidt, Boris
AU - Gunawardene, Melanie
AU - Schulte-Hahn, Britta
AU - Urban, Verena
AU - Bode, Frank
AU - Nowak, Bernd
AU - Chun, Julian K R
N1 - © 2012 Wiley Periodicals, Inc.
PY - 2013/5/1
Y1 - 2013/5/1
N2 - INTRODUCTION: The cryoballoon technology has the potential to isolate a pulmonary vein (PV) with a single energy application. However, using the first-generation cryoballoon (CB-1G) repeated freezing or additional focal ablation is often necessary. The novel second-generation cryoballoon (CB-2G) features a widened zone of optimal cooling comprising the whole frontal hemisphere. The aim of this study was to investigate the impact of the novel design on procedural efficacy of cryoballoon PV isolation (CB-PVI).METHODS AND RESULTS: Single transseptal CB-PVI using an endoluminal spiral mapping catheter was performed in 60 consecutive patients (CB-1G, 28 mm, 300 seconds application time: 30 patients; CB-2G, 28 mm, 240 seconds application time: 30 patients). When compared to the CB-1G, using the CB-2G increased single-shot PVI rate from 51% to 84% (P < 0.001) and decreased procedure duration (128 ± 27 vs 98 ± 30 minutes; P < 0.001), and fluoroscopy exposure time (19.5 ± 7.4 vs 13.4 ± 5.3 min; P = 0.001). Effective CB-2G PVI could be performed with increased real-time PVI visualization rate (49% vs 76%; P < 0.001). Time to PVI (T(PVI)) was shorter in the CB-2G group (79 ± 60 vs. 52 ± 36 seconds; P = 0.049). Procedure-related complications occurred in 2 patients in the CB-1G group and 1 patient in the CB-2G group.CONCLUSIONS: The CB-2G significantly improved procedural efficacy compared to the CB-1G and provided reliable T(PVI) measurement. T(PVI) may be used to adjust application time and number individually in future studies. Final conclusions regarding the safety profile of the CB-2G requires additional research.
AB - INTRODUCTION: The cryoballoon technology has the potential to isolate a pulmonary vein (PV) with a single energy application. However, using the first-generation cryoballoon (CB-1G) repeated freezing or additional focal ablation is often necessary. The novel second-generation cryoballoon (CB-2G) features a widened zone of optimal cooling comprising the whole frontal hemisphere. The aim of this study was to investigate the impact of the novel design on procedural efficacy of cryoballoon PV isolation (CB-PVI).METHODS AND RESULTS: Single transseptal CB-PVI using an endoluminal spiral mapping catheter was performed in 60 consecutive patients (CB-1G, 28 mm, 300 seconds application time: 30 patients; CB-2G, 28 mm, 240 seconds application time: 30 patients). When compared to the CB-1G, using the CB-2G increased single-shot PVI rate from 51% to 84% (P < 0.001) and decreased procedure duration (128 ± 27 vs 98 ± 30 minutes; P < 0.001), and fluoroscopy exposure time (19.5 ± 7.4 vs 13.4 ± 5.3 min; P = 0.001). Effective CB-2G PVI could be performed with increased real-time PVI visualization rate (49% vs 76%; P < 0.001). Time to PVI (T(PVI)) was shorter in the CB-2G group (79 ± 60 vs. 52 ± 36 seconds; P = 0.049). Procedure-related complications occurred in 2 patients in the CB-1G group and 1 patient in the CB-2G group.CONCLUSIONS: The CB-2G significantly improved procedural efficacy compared to the CB-1G and provided reliable T(PVI) measurement. T(PVI) may be used to adjust application time and number individually in future studies. Final conclusions regarding the safety profile of the CB-2G requires additional research.
KW - Aged
KW - Atrial Fibrillation
KW - Catheter Ablation
KW - Cryosurgery
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Operative Time
KW - Postoperative Care
KW - Postoperative Complications
KW - Pulmonary Veins
U2 - 10.1111/jce.12082
DO - 10.1111/jce.12082
M3 - SCORING: Journal article
C2 - 23398599
VL - 24
SP - 492
EP - 497
JO - J CARDIOVASC ELECTR
JF - J CARDIOVASC ELECTR
SN - 1045-3873
IS - 5
ER -