| Pulmonary vein electrophysiology during cryoballoon ablation as a predictor for procedural success. | |
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MedLine Citation:
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PMID: 21594628 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Cryoballoon technique is an innovative alternative to radiofrequency ablation for atrial fibrillation (AF). However, with current cryoballoon application techniques, the operator has no access to electrical information for 300 s during the freezing cycle. OBJECTIVE: The objective of this study is to investigate the novel approach of real-time monitoring of pulmonary vein (PV) potentials throughout freezing using a circular mapping catheter introduced into the central lumen of the cryoballoon catheter. METHODS: Patients had paroxysmal or persistent AF. Standard balloon catheters (23 or 28 mm diameter, 10.5 F shaft) were used. A coaxial mapping catheter (shaft diameter 0.9 mm; 15 mm loop with six electrodes) was advanced through the lumen of the cryoballoon catheter, replacing the guide wire. The primary procedural end point was successful PV isolation and real-time PV potential recording. Secondary end points were procedural data, complications, and the time to successful PV isolation. RESULTS: In 141 consecutively enrolled patients, balloon positioning and ablation were successful in 439/568 veins (77%). Real-time recording of PV conduction during the freeze cycle was possible in 235/568 PVs (41%). Main reasons for failure to obtain real-time PV recordings were a distal position of the circular mapping catheter or insufficient catheter-vessel wall contact during ablation. A cutoff value of 83 s to PV isolation was predictive of stable procedural PV isolation without reconduction. One minor hemoptysis was observed possibly related to the mapping catheter. CONCLUSIONS: This study, the largest to date, showed that real-time monitoring of PV conduction during cryoballoon freezing can be safely performed with a circular mapping catheter. A cutoff time of 83 s to PV isolation was predictive of sustained procedural PV isolation success without reconduction. |
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Authors:
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Uwe Dorwarth; Martin Schmidt; Michael Wankerl; Juergen Krieg; Florian Straube; Ellen Hoffmann |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-19 |
Journal Detail:
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Title: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing Volume: - ISSN: 1572-8595 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-5-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9708966 Medline TA: J Interv Card Electrophysiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Cardiology an Intensive Care Medicine, Heart Center Munich-Bogenhausen, Klinikum Bogenhausen, Englschalkinger Strasse 77, 81925, Munich, Germany, uwe.dorwarth@klinikum-muenchen.de. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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