4 results on '"Stroker, Erwin"'
Search Results
2. Single 3-minute versus Double 4-minute Freeze Strategy for Second-Generation Cryoballoon Ablation
- Author
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Ciconte, Giuseppe, Sieira-Moret, Juan, Hacioglu, Ebru, Mugnai, Giacomo, Di Giovanni, Giacomo, Velagic, Vedran, Saitoh, Yukio, Conte, Giulio, Irfan, Ghazala, Baltogiannis, Giannis, Hunuk, Burak, Stroker, Erwin, Brugada, Pedro, de Asmundis, Carlo, Chierchia, Jean-Baptiste, Faculty of Medicine and Pharmacy, Cardio-vascular diseases, and Clinical sciences
- Subjects
Medicine(all) ,cryoballoon ablation ,Phrenic nerve injury ,Second-generation cryoballoon ,paroxysmal atrial fibrillation ,Pulmonary vein isolation ,single freeze - Abstract
INTRODUCTION: . Second-generation cryoballoon (CB-Adv) ablation is highly effective in achieving pulmonary vein isolation (PVI) with promising mid-term clinical outcome. However, the ideal freezing strategy is still under debate. To assess the efficacy of a single 3-minutes approach compared to the conventional 4-minutes plus bonus application using CB-Adv. METHODS AND RESULTS: . One-hundred and sixty patients (67% male; mean age 58.0 ± 13.3 years) underwent PVI using CB-Adv for paroxysmal atrial fibrillation (PAF). Among 160 patients, 80 received a single 3-minutes approach (3-mns group), while the remaining 80 conventional 4-minutes plus bonus-freeze (4-mns group). Mean procedure and fluoroscopy times were 90.6 ± 15.8 and 18.3 ± 6.9 in the 4-mns Group, 75.2 ± 17.1 and 13.5 ± 8.7 in the 3-mns Group (p< 0.001, respectively). First-freeze isolation rate was 91.6% in the 4- vs 90.6% in the 3-mns group (p = 0.78). Persistent phrenic nerve palsy (PNP) occurred in 6/80 (3.5%) in the 4-mns group and 4/80 in the 3-mns group (p = 0.75). The overall freedom from ATas 2-years after the procedure was 78.1% (125/160): 77.5% (62/80 patients) in the 3-mns and 78.8% (63/80 patients) in the 4-mns Group (p = 0.82). In multivariate analysis, time to PVI and nadir temperature independently predicted ATa recurrences (p< 0.001). CONCLUSIONS: . CB-Adv ablation for PAF is highly effective resulting in 78% 2-year freedom from arrhythmic recurrences. A "single 3-minutes strategy" showed equal efficacy as compared to the conventional 4-minutes plus bonus freeze approach at 2-year follow-up, providing shorter procedure and fluoroscopy time. Nadir temperature and time to PVI were predictors of arrhythmic recurrences. "Bonus-freeze" strategy might be unnecessary. This article is protected by copyright. All rights reserved.
- Published
- 2016
3. Single 3-Minute versus Double 4-Minute Freeze Strategy for Second-Generation Cryoballoon Ablation: A Single-Center Experience.
- Author
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CICONTE, GIUSEPPE, SIEIRA‐MORET, JUAN, HACIOGLU, EBRU, MUGNAI, GIACOMO, GIOVANNI, GIACOMO, VELAGIC, VEDRAN, SAITOH, YUKIO, CONTE, GIULIO, IRFAN, GHAZALA, BALTOGIANNIS, GIANNIS, HUNUK, BURAK, STROKER, ERWIN, BRUGADA, PEDRO, ASMUNDIS, CARLO, and CHIERCHIA, GIAN‐BATTISTA
- Subjects
AMBULATORY electrocardiography ,ATRIAL fibrillation ,CHI-squared test ,COMPUTED tomography ,CONFIDENCE intervals ,CRYOSURGERY ,ECHOCARDIOGRAPHY ,FISHER exact test ,STATISTICAL hypothesis testing ,T-test (Statistics) ,TRANSESOPHAGEAL echocardiography ,PROPORTIONAL hazards models ,RETROSPECTIVE studies ,RECEIVER operating characteristic curves ,DATA analysis software ,DESCRIPTIVE statistics ,KAPLAN-Meier estimator - Abstract
Single 3 vs. Double 4 Strategy in CB ablation Introduction Second-generation cryoballoon (CB-Adv) ablation is highly effective in achieving pulmonary vein isolation (PVI) with promising mid-term clinical outcome. However, the ideal freezing strategy is still under debate. The aim of this study was to assess the efficacy of a single 3-minute approach compared to the conventional 4-minute plus bonus application using CB-Adv. Methods and Results One hundred and sixty patients (67% male; mean age 58.0 ± 13.3 years) underwent PVI using CB-Adv for paroxysmal atrial fibrillation (PAF). Among 160 patients, 80 received a single 3-minute approach (3-mns group), while the remaining 80 conventional 4-minute plus bonus-freeze (4-mns group). Mean procedure and fluoroscopy times were 90.6 ± 15.8 and 18.3 ± 6.9 in the 4-mns group, 75.2 ± 17.1 and 13.5 ± 8.7 in the 3-mns group (P < 0.001, respectively). First-freeze isolation rate was 91.6% in the 4- versus 90.6% in the 3-mns group (P = 0.78). Persistent phrenic nerve palsy (PNP) occurred in 6/80 (3.5%) in the 4-mns group and 4/80 in the 3-mns group (P = 0.75). The overall freedom from ATas 2 years after the procedure was 78.1% (125/160): 77.5% (62/80 patients) in the 3-mns and 78.8% (63/80 patients) in the 4-mns group (P = 0.82). In multivariate analysis, time to PVI and nadir temperature independently predicted ATa recurrences (P < 0.001). Conclusions CB-Adv ablation for PAF is highly effective, resulting in 78% 2-year freedom from arrhythmic recurrences. A 'single 3-minute strategy' showed equal efficacy as compared to the conventional 4-minute plus bonus freeze approach at 2-year follow-up, providing shorter procedure and fluoroscopy time. Nadir temperature and time to PVI were predictors of arrhythmic recurrences. 'Bonus-freeze' strategy might be unnecessary. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
4. Value of high-resolution mapping in optimizing cryoballoon ablation of atrial fibrillation.
- Author
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Conte, Giulio, Soejima, Kyoko, de Asmundis, Carlo, Chierchia, Gian-Battista, Badini, Matteo, Miwa, Yosuke, Caputo, Maria Luce, Özkartal, Tardu, Maffessanti, Francesco, Sieira, Juan, Degreef, Yves, Stroker, Erwin, Regoli, François, Moccetti, Tiziano, Brugada, Pedro, and Auricchio, Angelo
- Subjects
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PULMONARY veins , *ATRIAL fibrillation diagnosis , *ATRIAL fibrillation risk factors , *CATHETER ablation , *SURGERY - Abstract
Abstract Background Unrecognized incomplete pulmonary vein isolation (PVI), as opposed to post-PVI pulmonary vein reconnection, may be responsible for clinical recurrences of atrial fibrillation (AF). To date, no data are available on the use of high-resolution mapping (HRM) during cryoballoon (CB) ablation for AF as the index procedure. The aims of this study were: - to assess the value of using a HRM system during CB ablation procedures in terms of ability in acutely detecting incomplete CB lesions; - to compare the 8-pole circular mapping catheter (CMC, Achieve) and the 64-pole mini-basket catheter (Orion) with respect to pulmonary vein (PV) signals detection at baseline and after CB ablation; - to characterize the extension of the lesion produced by CB ablation by means of high-density voltage mapping. Methods Consecutive patients with drug-resistant paroxysmal or early-persistent AF undergoing CB ablation as the index procedure, assisted by a HRM system, were retrospectively included in this study. Results A total of 33 patients (25 males; mean age: 59 ± 18 years, 28 paroxysmal AF) were included. At baseline, CMC catheter revealed PV activity in 102 PVs (77%), while the Orion documented PV signals in all veins (100%). Failure of complete CB-PVI was more frequently revealed by atrial re-mapping with the Orion as compared to the Achieve catheter (24% vs 0%, p < 0.05). A repeat ablation was performed in 8 patients (24%). In 9% of cases, the Orion catheter detected far-field signals originating from the right atrium. Quantitative assessment of the created lesion revealed a significant reduction of the left atrial area having voltage >0.5 mV. A total of 29 patients (88%) remained free of symptomatic AF during a mean follow-up of 13.2 ± 3.7 months. Conclusion Atrial re-mapping after CB ablation by means of a HRM system improves the detection of areas of incomplete ablation, characterizes the extension of the cryo-ablated tissue and can identify abolishment of potential non-PVI related sources of AF. Highlights • Unrecognized incomplete PVI may be responsible for clinical recurrences of AF. • Identification of incomplete acute efficacy of PVI is clinically relevant. • Atrial high-resolution mapping enables accurate detection of incomplete CB-PVI. • Atrial high-resolution mapping characterizes the extension of cryoablation. • High-resolution mapping identifies abolishment by CB of non-PVI related sources of AF. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
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