Imaging before cryoablation of atrial fibrillation: is phrenic nerve palsy predictable?

Canpolat, Uğur; Aytemir, Kudret; Hizal, Mustafa; Hazırolan, Tuncay; Yorgun, Hikmet; Şahiner, Levent; Kaya, E.B.; Oto, Ali̇

doi:10.1093/eurheartj/eht308.p2322

Cited by 2 publications

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“…Besides temperature characteristics during the cryo freeze, the anatomic relation between cryoballoon positioning and right phrenic nerve anatomy determines the risk of phrenic nerve palsy during cryo PVI procedures. 8,9 Intraprocedural right phrenic F I G U R E 4 RAO and LAO views after 3D image integration. Segmented cardiac anatomy was aligned to its fluoroscopic counterparts during the registration process before transseptal puncture.…”

Section: Visualization Of Anatomymentioning

confidence: 99%

Three‐dimensional image integration guidance for cryoballoon pulmonary vein isolation procedures

Bourier

Vlachos

Lam

et al. 2019

Cardiovasc electrophysiol

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Background We present a new, easily applicable approach for the guidance of cryoballoon (CB) pulmonary vein isolation (PVI) procedures that use the combination of a 3D‐mapping system image integration module and computed tomographic (CT)–derived anatomy. The aim of this retrospective, nonrandomized study was to investigate: (a) an alternative use for an established radiofrequency image integration module for cryo procedures; (b) a guidance technology for cryo PVI based on integrated CT anatomy; and (c) its clinical impact. Methods and results CT left atrium–angiography was performed in 50 consecutive patients before a CB PVI procedure, and a 3D reconstruction of the cardiac anatomy was segmented. A total of 25 patients were treated using conventional fluoroscopy; 25 patients were treated using the 3D image integration technique. In the image integration group, the CARTO3 UNIVU (Biosense Webster) module was used for image integration of 3D anatomy and fluoroscopic imaging. Transseptal puncture and cryo PVI were guided by 3D‐overlay imaging. Procedures were feasible without complications in all patients and cryo PVI procedures were successfully guided using the image integration technique. The intraprocedural time needed to perform image integration was 37 ± 10 seconds. Fluoroscopy time was 31.7 ± 11.7 minutes in the conventional group and 20.1 ± 7.9 minutes in the image integration group (P < .001), procedure time was 116.3 ± 29.0 minutes in the conventional group vs 101.2 ± 20.9 minutes in the 3D group (P = .04). Conclusion 3D‐overlay guidance of CB PVI is feasible, safe, and applicable in real time with minimal effort. It may significantly reduce radiation exposure by introducing 3D information, known from electroanatomic mapping systems, into cryo PVI procedures.

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Section: Visualization Of Anatomymentioning

confidence: 99%

Three‐dimensional image integration guidance for cryoballoon pulmonary vein isolation procedures

Bourier

Vlachos

Lam

et al. 2019

Cardiovasc electrophysiol

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“…Detailed anatomic study using 1.5-T MRI demonstrated that those with PNP had a significantly shorter distance from RSPV ostium to lateral border of the SVC (14.0 mm ± 2.3 vs 17.1 mm ± 2.8, P = 0.03). In another recent imaging study using multidetector CT, Canpolat et al 7 studied 162 patients prior to cryoablation for AF. Among 4/145 patients with PNP (all transient, resolving within 24 hours) the distance between the RSPV ostium and right percardiophrenic artery (which runs alongside the nerve) was significantly less.…”

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confidence: 99%

Phrenic Nerve Damage from Cryoablation: Dealbreaker or Just a Hiccup?

Gula

2013

Cardiovasc electrophysiol

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Imaging before cryoablation of atrial fibrillation: is phrenic nerve palsy predictable?

Cited by 2 publications

References 0 publications

Three‐dimensional image integration guidance for cryoballoon pulmonary vein isolation procedures

Three‐dimensional image integration guidance for cryoballoon pulmonary vein isolation procedures

Phrenic Nerve Damage from Cryoablation: Dealbreaker or Just a Hiccup?

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