Characterization of conduction recovery after pulmonary vein isolation using the “single big cryoballoon” technique

Fürnkranz, Alexander; Chun, K.R. Julian; Nuyens, Dieter; Metzner, Andreas; Köster, Ilka; Schmidt, Boris; Ouyang, Feifan; Kuck, Karl‐Heinz

doi:10.1016/j.hrthm.2009.10.038

Cited by 95 publications

(64 citation statements)

References 12 publications

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“…Conversely to RF catheter ablation, however, energy titration is not possible using cryoballoon ablation, and assuming an appropriate PV/balloon contact, the same amount of energy is delivered all around the PV ostia. Similarly to what has been recently described by Furnkranz et al using the single big cryoballoon technique, 8 we found that PV reconnections predominantly occurred at the ridge between the LSPV and the left atrial appendage. Difficulties in creating a transmural lesion with the cryoballoon would pave the way for conduction recovery at this particular anatomical site.…”

Section: Procedure-related Parameterssupporting

confidence: 90%

Lessons From Radiofrequency Redo-Procedure After Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation

Godin

Savouré

Gardey

et al. 2013

Circ J

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Section: Procedure-related Parameterssupporting

confidence: 90%

Lessons From Radiofrequency Redo-Procedure After Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation

Godin

Savouré

Gardey

et al. 2013

Circ J

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“…Using the first-generation CB, the rate of electric reconduction was 54%. 21 For the secondgeneration CB, only a single study evaluated the incidence of PV reconduction. 22 In 18 patients admitted for reablation because of recurrent ATA, persistent electric isolation was demonstrated in 55 of 71 (77%) previously isolated PVs, whereas in 6 of 18 (33%) patients, all 4 PVs were still isolated.…”

Section: Discussionmentioning

confidence: 99%

Once Isolated, Always Isolated?

Heeger

Wißner

Mathew

et al. 2015

Circ: Arrhythmia and Electrophysiology

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The regular TS was exchanged over a guidewire for a 12F steerable TS (Flexcath Advance, Medtronic Inc., Minneapolis, MN). The © 2015 American Heart Association, Inc. Original ArticleBackground-The second-generation cryoballoon delivers effective pulmonary vein isolation (PVI) associated with superior 1-year clinical outcome. However, data on reconduction of previously isolated PV are sparse. Methods and Results-A total of 421 patients underwent second-generation 28-mm cryoballoon-based PVI in 2 centers (St.George's hospital and Harburg hospital, Hamburg, Germany) between June 2012 and May 2015. Sixty-six of 421 (16%) patients (39/66, 59% women; mean age, 63±10 years, mean left atrium diameter, 45±6 mm) with a history of paroxysmal (40/66, 61%) or persistent atrial fibrillation and atrial tachyarrhythmia recurrences despite previous successful secondgeneration 28-mm cryoballoon-based PVI were included in this analysis. During the index PVI, the standard freeze cycle duration was 240 s. After successful PVI, a bonus freeze cycle of 240 s was applied in the first 15 of 66 (23%) patients, whereas no bonus freeze cycle was applied in the remaining patients. Repeat procedures were performed after a median of 205 (131-357) days following the index ablation. Electric reconduction was assessed for all PVs, and reablation was performed using radiofrequency energy. Persistent electric isolation was noted in 178 of 258 (69%) PVs. In 17 of 66 (26%) patients, all previously targeted PVs remained isolated. A significant difference toward highest reconduction rate for the posteroinferior segment of the right inferior PV was found (P=0.0002). Conclusions-The second-generation cryoballoon ablation is associated with a high rate of persistent PVI. The posteroinferior segment of the right inferior PV showed the highest reconduction rate and seems to be a predilection site for PV reconduction.

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“…462,482 More than 80% of the patients with AF recurrence after first-generation CB-based PVI demonstrated recurrence of conduction at the time of a repeat ablation procedure. 483 The second-generation CB (Arctic Front Advance, Medtronic, Inc.) was introduced in 2012 and incorporates a modified refrigerant injection system characterized by 8 injection jets in a more distal balloon position. Thus, a more homogeneous cooling of the complete distal balloon hemisphere, including the distal tip, was achieved.…”

Section: Section 5: Strategies Techniques and Endpointsmentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

1,763

1,468

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Characterization of conduction recovery after pulmonary vein isolation using the “single big cryoballoon” technique

Cited by 95 publications

References 12 publications

Lessons From Radiofrequency Redo-Procedure After Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation

Lessons From Radiofrequency Redo-Procedure After Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation

Once Isolated, Always Isolated?

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

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