Best practice guide for cryoballoon ablation in atrial fibrillation: The compilation experience of more than 3000 procedures

Su, Wilber; Kowal, Robert C.; Kowalski, Marcin; Metzner, Andreas; Svinarich, John T.; Wheelan, Kevin; Wang, Paul

doi:10.1016/j.hrthm.2015.03.021

Cited by 204 publications

(243 citation statements)

References 33 publications

(66 reference statements)

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“…However, it is important to acknowledge the cryoballoon training program and recent publications sharing cryoballoon best practices as references for new cryoballoon users. 16 Although one may expect longer procedure times with operators who are new to the cryoballoon procedure, and a higher rate of repeat procedures, this was not the case in the CRYO-Japan PMS study when compared with the pivotal STOP-AF study. 5 The total laboratory occupancy time in STOP-AF was 371 min, compared with 188 min in the CRYOJapan PMS.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Safety and Efficacy of Cryoballoon Ablation for Paroxysmal Atrial Fibrillation in Japan　– Results From the Japanese Prospective Post-Market Surveillance Study –

Okumura

Matsumoto

Kobayashi

et al. 2016

Circ J

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Section: Clinical Outcomesmentioning

confidence: 99%

Safety and Efficacy of Cryoballoon Ablation for Paroxysmal Atrial Fibrillation in Japan　– Results From the Japanese Prospective Post-Market Surveillance Study –

Okumura

Matsumoto

Kobayashi

et al. 2016

Circ J

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“…The second-generation cryoballoon (CB2, Arctic Front Advance, Medtronic, Inc., Minneapolis, MN, USA) used for pulmonary vein isolation (PVI) has demonstrated high acute success rates and excellent 1-year clinical outcome data [1]. Applying different ablation protocols with and without a bonus freeze-cycle and different freeze-cycle durations in patients with paroxysmal atrial fibrillation (PAF), the 1-year clinical success rates after a single ablation procedure range from 80 to 84 % [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Two-year outcome after pulmonary vein isolation using the second-generation 28-mm cryoballoon: lessons from the bonus freeze protocol

et al. 2015

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“…Soft tissue adhesions make it necessary to use relatively large forces to introduce the sheaths. One of the techniques facilitating their introduction through the puncture is predilatation with a short large diameter sheath, for example 14 Fr [1,6,7].…”

Section: Discussionmentioning

confidence: 99%

“…The need for a more efficient method of sheath introduction, requiring less force, provided the motivation to modify the existing method with the use of the techniques described and used earlier for other types of procedure [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“Buddy wire” for facilitation of femoral venous access for cryoablation: a preliminary report

et al. 2017

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A b s t r a c tBackground: Some electrophysiological techniques, such as balloon cryoablation, involve the use of steerable sheaths of large diameter (outer diameter 15 Fr or more). Their introduction to the femoral vein may be difficult, especially in patients who have had numerous venipunctures in this area. Aim:The authors describe a modification of typical venous access with the use of a "buddy wire" technique, facilitating the insertion of the cryoablation sheaths to the femoral vein. Methods:A case-control study. The study involved a retrospective analysis of 27 consecutive procedures of balloon cryoablation of pulmonary veins performed in 2015 by the first author, compared to 23 consecutive procedures of balloon cryoablation performed in 2014 without a "buddy wire" technique. The study and control groups did not vary significantly. There were 11 women in both groups. The average age of the patients was 55.9 years. The "buddy wire" technique was the only difference in procedure performance between the control and study groups. In the study group a short introducer was inserted through a puncture of the right femoral vein, and then two wires were introduced through it. One of them was secured, so that it could not move, while the other served as a typical trans-septal puncture monitored with the use of X-ray. The standard trans-septal sheet was replaced with a 15 Fr steerable sheath, inserted through the same puncture site next to the secured "buddy wire". The short wire was then removed from the femoral vein. Typical balloon cryoablation of pulmonary veins was performed. After the end of the procedure, the puncture site was secured with a haemostatic suture for 12-18 h. Results:Femoral access with a 15 Fr steerable sheath and cryoablation were safely performed in all patients in the study group and in 22 out of 23 in the control group (100% vs. 95.6%, p = NS). Pulmonary vein isolation in one patient was performed using another technique. No damage to steerable sheaths was observed. There were no vascular complications requiring extended hospitalisation, blood transfusion, or surgical interventions in either group. The "door-to-door" time of the procedures ranged from 2 h 32 min on average in the study group to 2 h 43 min on average in the control group (p = NS). There was significant reduction in fluoroscopy time: 7 min 15 s on average from 11 min 25 s (p = 0.0009). Conclusions:The use of the "buddy wire" technique may lead to significant reduction in fluoroscopy time during cryoablation of pulmonary veins by facilitating the insertion of the steerable sheaths to the femoral vein.

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Best practice guide for cryoballoon ablation in atrial fibrillation: The compilation experience of more than 3000 procedures

Abstract: Comprehensive review of the CB2 ablation best practice guide will provide a detailed technique for achieving safer and more effective outcomes for CB2 atrial fibrillation ablation.

Cited by 204 publications

References 33 publications

Safety and Efficacy of Cryoballoon Ablation for Paroxysmal Atrial Fibrillation in Japan　– Results From the Japanese Prospective Post-Market Surveillance Study –

Safety and Efficacy of Cryoballoon Ablation for Paroxysmal Atrial Fibrillation in Japan　– Results From the Japanese Prospective Post-Market Surveillance Study –

Two-year outcome after pulmonary vein isolation using the second-generation 28-mm cryoballoon: lessons from the bonus freeze protocol

“Buddy wire” for facilitation of femoral venous access for cryoablation: a preliminary report

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Best practice guide for cryoballoon ablation in atrial fibrillation: The compilation experience of more than 3000 procedures

Abstract: Comprehensive review of the CB2 ablation best practice guide will provide a detailed technique for achieving safer and more effective outcomes for CB2 atrial fibrillation ablation.

Cited by 204 publications

References 33 publications

Safety and Efficacy of Cryoballoon Ablation for Paroxysmal Atrial Fibrillation in Japan – Results From the Japanese Prospective Post-Market Surveillance Study –

Safety and Efficacy of Cryoballoon Ablation for Paroxysmal Atrial Fibrillation in Japan – Results From the Japanese Prospective Post-Market Surveillance Study –

Two-year outcome after pulmonary vein isolation using the second-generation 28-mm cryoballoon: lessons from the bonus freeze protocol

“Buddy wire” for facilitation of femoral venous access for cryoablation: a preliminary report

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Safety and Efficacy of Cryoballoon Ablation for Paroxysmal Atrial Fibrillation in Japan　– Results From the Japanese Prospective Post-Market Surveillance Study –

Safety and Efficacy of Cryoballoon Ablation for Paroxysmal Atrial Fibrillation in Japan　– Results From the Japanese Prospective Post-Market Surveillance Study –