Background
Second-generation cryoballoon ablation is safe and effective in patients with paroxysmal (PAF) and persistent atrial fibrillation (AF).
Objective
This study aimed to assess the long-term clinical outcomes and freedom from AF in patients undergoing thermal-guided cryoablation without the use of an electrical mapping catheter.
Methods
All patients who had undergone thermal-guided second-generation cryoablation without electrical mapping between January 2015 and April 2018 at Eastbourne District General Hospital were retrospectively analysed. Success was defined as freedom from atrial arrhythmia lasting >30 s during the follow up period.
Results
The study included 234 patients with a mean age of 65.3 ± 10.6 years. There were 134 (57.0%) and 100 (42.7%) patients who had PAF and persistent AF respectively.
Arrhythmia recurrence occurred in 38 of 134 (28.4%) PAF and 42 of 100 (42.0%) persistent AF patients after mean follow up of 40 ± 9.2 months. The patients with PAF had a significantly greater freedom from arrhythmia than patients with persistent AF (p = .040). The mean procedure time was 55.5 ± 12.2 min and the mean fluoroscopy time was 10.9 ± 4.8 min 73.5% of patients were discharged on the same day.
Conclusion
Thermal-guided cryoablation is feasible, safe and results in freedom from arrhythmia in the majority of paroxysmal and persistent AF patients in the long term. Randomised controlled trials are required to confirm the findings of this study.
colonoscopic technique from Taiwan which facilitates easier placement of the snare thereby achieving en-bloc resection. Methods A 67 year old lady presented to our institute with an altered bowel habit and was found to have a flat polyp in the sigmoid colon on colonoscopy. Results Standard injection as per conventional endoscopic mucosal resection was initially performed. Then a suitably sized snare was selected and the snare tip was used to make a single incision with cut current lateral to the polyp. The snare tip was then anchored at the site of the incision and then the snare was slowly opened and simultaneously positioned around the polyp. Once the snare was adequately placed the polyp was resected. Histology revealed a tubulovillous adenoma with low grade dysplasia which was excised completely.Conclusions This technique provides an easy and safe way to resect en-bloc flat, large and challenging colonic polyps.
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