Title: Cryoballoon Pulmonary Vein Isolation with Real-Time Recordings from the Pulmonary Veins
Authors: Chun, K R Julian ×
Fürnkranz, Alexander
Metzner, Andreas
Schmidt, Boris
Tilz, Roland
Zerm, Thomas
Köster, Ilka
Nuyens, Dieter
Wissner, Erik
Ouyang, Feifan
Kuck, Karl Heinz #
Issue Date: Nov-2009
Publisher: Futura Pub.
Series Title: Journal of Cardiovascular Electrophysiology vol:20 issue:11 pages:1203-1210
Abstract: Pulmonary Vein Conduction During Cryoballoon Ablation. Introduction: Cryoballoon (CB) ablation represents a novel technology for pulmonary vein isolation (PVI). We investigated feasibility and safety of CB-PVI, utilizing a novel spiral catheter (SC), thereby obtaining real-time PV potential registration. Methods: Following double transseptal puncture, a Lasso catheter (Biosense Webster, Diamond Bar, CA, USA) and the 28 mm CB were positioned within the left atrium. A novel SC (Promap, ProRhythm Inc., Ronkonkoma, NY, USA) was inserted through the lumen of the CB allowing PV signal registration during treatment. Time to PV conduction block was analyzed. If no stable balloon position was obtained, the SC was exchanged for a regular guide wire and PV conduction was assessed after treatment by Lasso catheter. Results: In 18 patients, 39 of 72 PVs (54%) were successfully isolated using the SC. The remaining 33 PVs were isolated switching to the regular guide wire. Time to PV conduction block was significantly shorter in PVs in which sustained PVI was achieved as compared to PVs in which PV conduction recovered within 30 minutes (33 +/- 21 seconds vs 99 +/- 65 seconds). In 40 PVs, time to PV conduction block was not obtained because of: (1) PVI not being achieved during initial treatment; (2) a distal position of the SC; or (3) isolation with regular guide wire. No procedural complications occurred. Conclusion: Visualization of real-time PV conduction during CB PVI is safe, feasible, and allows accurate timing of PVI onset in a subset of PVs. Time to PV conduction block predicts sustained PVI. However, mechanical properties of the SC need to be improved to further simplify CB PVI. (J Cardiovasc Electrophysiol, Vol. pp. 1-8).
ISSN: 1045-3873
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Faculty of Medicine - miscellaneous
× corresponding author
# (joint) last author

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