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Pulmonary vein re-mapping after cryoballoon ablation for atrial fibrillation.
- Source :
-
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2018 Jun 01; Vol. 20 (6), pp. 943-948. - Publication Year :
- 2018
-
Abstract
- Aims: Establishment of pulmonary vein isolation (PVI) during cryoballoon (CB) ablation is generally confirmed by use of an octapolar inner-lumen mapping catheter (Achieve®). The aim of this study is to evaluate the residual PV potential (PVP) using the conventional circular catheter after CB-PVI.<br />Methods and Results: A total of 105 consecutive patients (418 PVs) with paroxysmal AF who underwent the initial CB-PVI were prospectively included in this study. Of those, 305 (73%) PVs with real-time recordings of PVP elimination by Achieve® catheter during successful PVI were included. After isolation of all 4 PVs, PV antral remapping by conventional circular mapping catheter was performed. After CB-PVI, residual PVP was detected in 4.3% (13/305) of PVs (1.2% of left-superior PV, 2.5% of left-inferior PV, none of right-superior PV, and 20% of right-inferior PV). Almost 60% of residual PV potential was located around the bottom portion of the right-inferior PV. In PVs with residual potential, PV trunk was shorter (12.7 ± 5.7 mm vs. 18.7 ± 7.9, P = 0.001), minimal balloon temperature was higher (-46.6 ± 5.9 °C vs. -50.9 ± 8.2, P = 0.02), and balloon warming time was shorter (35.6 ± 17.8 s vs. 50.0 ± 22.8, P = 0.006) than those without. All residual potentials were eliminated by additional touch up ablation. After the initial ablation procedure, 1-year AF-free rate was 79.5%.<br />Conclusion: PV remapping after CB-PVI revealed residual antral PVP in 4.3% of PVs and in 20% of RIPVs in particular. The Achieve® catheter sometimes fails to detect complete PV antral isolation.
- Subjects :
- Aged
Equipment Design
Female
Heart Conduction System diagnostic imaging
Heart Conduction System physiopathology
Humans
Japan
Male
Middle Aged
Reproducibility of Results
Treatment Outcome
Atrial Fibrillation diagnosis
Atrial Fibrillation surgery
Cardiac Catheters
Cryosurgery instrumentation
Cryosurgery methods
Electrophysiologic Techniques, Cardiac instrumentation
Electrophysiologic Techniques, Cardiac methods
Postoperative Care instrumentation
Postoperative Care methods
Pulmonary Veins diagnostic imaging
Pulmonary Veins surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2092
- Volume :
- 20
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 29016768
- Full Text :
- https://doi.org/10.1093/europace/eux129