Long-Term Follow-Up After Cryothermic Ostial Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation

Moreira, Wendel; Manusama, Randy; Timmermans, Carl; Ghaye, Benoît; Philippens, Suzanne; Wellens, Hein J.J.; Rodriguez, Luz‐Maria

doi:10.1016/j.jacc.2007.08.065

Cited by 25 publications

(16 citation statements)

References 35 publications

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“…1(c) and (d)] solely on balloon substrates to conform to the anatomical structure of the heart [14]- [16]. These balloons inflate within the left atrium and create continuous rings of conformal contact between the balloon and the tissue followed by delivery of cryo-or laser-based ablation therapies.…”

Section: Instrumented Cardiac Ablation Cathetersmentioning

confidence: 99%

Catheter-Based Systems With Integrated Stretchable Sensors and Conductors in Cardiac Electrophysiology

et al. 2015

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We present novel mechanics, materials and integration strategies for this new class of bioelectronics onboard minimally invasive catheter based systems. Representative examples highlight the clinical significance soft biointegrated electronics. ABSTRACT | Established classes of high-performance electronics have driven advances in interventional biomedicine. However, the large size, planar geometry and stiff mechanical properties of standard conventional electronics employed in medical devices give rise to important integration challenges with soft biological tissue. Stretchable and flexible biointegrated electronics could improve treatment procedures across a broad range of applications, including cardiac, neural and endovascular therapies. Here we present novel mechanics, materials and integration strategies for this new class of bioelectronics onboard minimally invasive catheter based systems. Co-located arrays of sensors and actuators affixed to cardiacManuscript

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Section: Instrumented Cardiac Ablation Cathetersmentioning

confidence: 99%

Catheter-Based Systems With Integrated Stretchable Sensors and Conductors in Cardiac Electrophysiology

et al. 2015

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“…This balloon-based ablation system isolated PVs by freezing the tissue that lies in contact with a balloon that is cooled to Ϫ80°C. 43,44 This ablation system has been approved for clinical use for many years in Europe and has recently been released for clinical use in the United States. The results of the clinical trial have been published in abstract form.…”

Section: New Techniques and Toolsmentioning

confidence: 99%

Catheter Ablation to Maintain Sinus Rhythm

Calkins

2012

Circulation

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“…This system achieves PVI by freezing atrial tissue that comes into contact with a balloon that is cooled to -80°C. 56,57 The results of the United States based trial have been published in abstract form. Provisionally, the authors suggest a benefit as compared to ablation.…”

Section: Emerging Technologiesmentioning

confidence: 99%

“…56,57 Another balloon based PV ablation system uses laser energy produced by a diode laser to create atrial lesions.…”

Section: Emerging Technologiesmentioning

confidence: 99%

“…There is little data to suggest a role for these systems, although clinical trials are underway in order to do so. 55,56 Finally, a hybrid thoracoscopic and transvenous catheter approach has been investigated in a recent prospective single centre study. The authors report a single procedure success rate of 86 % for the 26 patients who enrolled.…”

Section: Emerging Technologiesmentioning

confidence: 99%

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Catheter Ablation of Atrial Fibrillation – Techniques and Technology

Katritsis

Calkins

2012

Arrhythmia &Amp; Electrophysiology Review

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Over the past decades catheter ablation of atrial fibrillation (AF) has evolved from being a largely experimental procedure to a well-established therapeutic option for certain patients with AF. [1][2][3][4] Currently the backbone of most catheter ablation techniques is to target the pulmonary veins (PVs) in order to achieve their electrical isolation and maintain sinus rhythm (SR).1 Additional techniques may be used to ablate non-PV triggers and candidate atrial sites considered responsible for maintaining AF.1 Drawing upon our experience and our literature review, we would estimate the single procedure efficacy of AF ablation in an "optimal" candidate for AF ablation to be between 60 % and 80 %. The single procedure in a less optimal patient, such as a patient with persistent AF, lies between 50 % and 70 %. The single efficiency of the procedure in a suboptimal patient, such as a patient with continuous AF for four years, is 40 % or less. It is important to recognise that AF may recur following ablation and that patients may need a second procedure for which the success rate is cumulative.In this paper we will initially describe the reasons why we may consider catheter ablation as a treatment for AF. We will then discuss the current ways by which catheter ablation for AF is performed.We will review the relative efficency of ablation compared to other treatment options. Finally, we will discuss what the future may hold for AF ablation procedures and how these may impact on current success rates and safety of AF ablation. Rationale for Catheter Ablation of AFAs outlined by the HRS Consensus Document on AF ablation, the primary indication for AF ablation is the presence of symptomatic AF refractory, or intolerant, to at least one class 1 or 3 antiarrhythmic (AA) medication. 1 In specific situations, ablation may be considered as a first line treatment for AF; however this is not common practice.The most common reason to pursue catheter ablation for AF is to reduce the patient's AF burden. Therefore, ablation is performed to relieve symptoms and improve quality of life. 1-3,5 As of today, it remains uncertain whether maintaining SR affects patient survival and, especially, stroke risk. 6-13 However it appears that catheter ablation is more effective at maintaining SR as compared to AA therapy. Hopefully the CABANA study will provide insight into this and other important questions regarding the outcome of maintaining AF patients in SR by catheter ablation.Typically, higher procedural success rates are reported in patients with paroxysmal AF and minimal structural heart disease. 1,5 Yet published data also supports a role for catheter ablation in patients who were previously deemed unsuitable. Benefit from ablation has been reported in patients with heart failure 14-17 and long-standing persistent AF. Diagnostic Electrophysiology and Ablation AbstractFor certain patients with atrial fibrillation (AF) catheter ablation is now an important, therapeutic, intervention. It is established that catheter ablation is mo...

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Long-Term Follow-Up After Cryothermic Ostial Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation

Abstract: Pulmonary vein cryoisolation is effective in 82% of patients with recent-onset PAF during a mean follow-up of 33 +/- 15 (range 15 to 60) months. If the arrhythmogenic PV is identified and isolated, the long-term outcome is excellent, indicating no need to isolate all PVs.

Cited by 25 publications

References 35 publications

Catheter-Based Systems With Integrated Stretchable Sensors and Conductors in Cardiac Electrophysiology

Catheter-Based Systems With Integrated Stretchable Sensors and Conductors in Cardiac Electrophysiology

Catheter Ablation to Maintain Sinus Rhythm

Catheter Ablation of Atrial Fibrillation – Techniques and Technology

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