Document Detail


Combined use of cryoballoon and focal open-irrigation radiofrequency ablation for treatment of persistent atrial fibrillation: results from a pilot study.
MedLine Citation:
PMID:  20188229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary vein isolation (PVI) achieved using a cryoballoon has been shown to be safe and effective. This treatment modality has limited effectiveness for treatment of persistent atrial fibrillation (AF). OBJECTIVE: The purpose of this study was to evaluate a combined approach using a cryoballoon for treatment of PVI and focal radiofrequency (RF) left atrial substrate ablation for treatment of persistent AF. METHODS: Twenty-two consecutive patients with persistent AF were included in the study. PVI initially was performed with a cryoballoon. Left atrial complex fractionated atrial electrograms (CFAEs) then were ablated using an RF catheter. Finally, linear ablations using the RF catheter were performed. RESULTS: Eighty-three PVs, including five with left common ostia, were targeted and isolated (100%). Seventy-seven (94%) of 82 PVs targeted with the cryoballoon were isolated, and 5 (6%) required use of RF energy to complete isolation. A mean of 9.7 +/- 2.6 cryoablation applications per patient was needed to achieve PVI. Median time required for cryoablation per vein was 600 seconds, and mean number of balloon applications per vein was 2.5 +/- 1.0. In 19 (86%) patients in whom AF persisted after PVI, CFAE areas were ablated using the RF catheter. Two cases of transient phrenic nerve paralysis occurred. After a single procedure and mean follow-up of 6.0 +/- 2.9 months, 86.4% of patients were AF-free without antiarrhythmic drugs. CONCLUSION: A combined approach of cryoablation and RF ablation for treatment of persistent AF is feasible and is associated with a favorable short-term outcome.
Authors:
Moussa Mansour; Giovanni B Forleo; Augusto Pappalardo; Conor Barrett; E Kevin Heist; Andrea Avella; Gianluigi Bencardino; Antonio Dello Russo; Michela Casella; Jeremy N Ruskin; Claudio Tondo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-12-24
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  7     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-22     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  452-8     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Massachusetts General Hospital, Heart Center, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / therapy*
Catheter Ablation*
Combined Modality Therapy
Cryotherapy / instrumentation*
Feasibility Studies
Humans
Irrigation
Middle Aged
Pilot Projects
Pulmonary Veins / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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