European Heart Journal Advance Access published online on June 14, 2007
European Heart Journal, doi:10.1093/eurheartj/ehm227
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Pulmonary vein isolation using an occluding cryoballoon for circumferential ablation: feasibility, complications, and short-term outcome
Clinical Electrophysiology Unit, Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Dr Molewaterplein 40, Room BD416, 3015 GD Rotterdam, The Netherlands
Received 12 March 2007; revised 1 May 2007; accepted 10 May 2007.
* Corresponding author. Tel: +31 104633991; fax: +31 104634420. E-mail address: y.vanbelle{at}erasmusmc.nl
Aims: To assess safety, feasibility and short term outcome of pulmonary vein (PV) isolation in paroxysmal atrial fibrillation (AF) with a cryoballoon.
Methods: We consecutively treated 57 patients with a double lumen 23 or 28 mm cryoballoon. The acute results, complications and follow-up over the first three months were analysed, using a comprehensive and intensive follow-up period.
Results: During 57 procedures, 185 of 220 targeted PV's were successfully isolated using the cryoballoon (84%) (balloon group, 33 patients). In 33 veins (15%) an additional segmental isolation (hybrid group, 24 patients) was necessary with a standard cryocatheter to achieve isolation. The average procedure times were respectively 211 ± 108 and 261 ± 83 minutes (NS), the average fluoroscopy times 52 ± 36 and 66 ± 33 minutes (NS). The number of balloon applications did not differ between both groups: respectively a median 9 (4–18) and 10 (5–17) (NS). We observed four phrenic nerve paralysis after ablation of the right superior PV: two resolved immediately after cessation of the cryoenergy, one recovered after 3 months, one persisted up to 6 months. A daily transtelephonic rhythm recording showed a significant drop in mean AF burden from 24% to 10%, 8% and 5% during the three consecutive months of follow-up (p < 0.01 versus baseline). No differences were observed between the treatment groups. 34 patients (60%) were completely free from AF after a single procedure.
Conclusions: Balloon cryoablation of the pulmonary veins with additional segmental isolation if necessary, is a good approach for patients presenting with paroxysmal AF, showing a significant reduction in AF burden after a single procedure. The major complication seems to be phrenic nerve paralysis after ablation of the right superior PV, but this is potentially reversible over several months.
Key Words: Clinical electrophysiology • Atrial fibrillation • Pulmonary vein isolation • Catheter ablation • Cryothermal • Balloon
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Jensen-Urstad, H. Bastani, F. Braunschweig, N. Drca, P. Insulander, G. Kenneback, J. Schwieler, and F. Tabrizi Cryoballoon ablation: a novel technique for treating focal atrial tachycardias from the pulmonary veins Europace, November 1, 2009; 11(11): 1445 - 1447. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. B. Chierchia, Y. Yazaki, A. Sorgente, L. Capulzini, C. de Asmundis, A. Sarkozy, M. Duytschaever, R. De Ponti, and P. Brugada Transient atriovenous reconnection induced by adenosine after successful pulmonary vein isolation with the cryothermal energy balloon Europace, October 31, 2009; (2009) eup339v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Metzner, K.R. J. Chun, D. Kivelitz, and K.-H. Kuck Successful Transseptal Puncture and Cryoballoon Pulmonary Vein Isolation in Adverse Anatomy: Interrupted Inferior Caval Vein and Azygos Continuation Circ Arrhythm Electrophysiol, October 1, 2009; 2(5): e24 - e27. [Full Text] [PDF]
|
|
|
|
|
|
B. Schmidt, K. R. J. Chun, A. Metzner, A. Fuernkranz, F. Ouyang, and K.-H. Kuck Pulmonary vein isolation with high-intensity focused ultrasound: results from the HIFU 12F study Europace, October 1, 2009; 11(10): 1281 - 1288. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Rajappan, V. Baker, L. Richmond, P. M. Kistler, G. Thomas, C. Redpath, S. C. Sporton, M. J. Earley, S. Harris, and R. J. Schilling A randomized trial to compare atrial fibrillation ablation using a steerable vs. a non-steerable sheath Europace, May 1, 2009; 11(5): 571 - 575. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. B. Chierchia, C. de Asmundis, S.-A. Muller-Burri, A. Sarkozy, L. Capulzini, G. Paparella, S. Chierchia, M. Roos, and P. Brugada Early recovery of pulmonary vein conduction after cryoballoon ablation for paroxysmal atrial fibrillation: a prospective study Europace, April 1, 2009; 11(4): 445 - 449. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Van Belle and L. Jordaens Reflections on reconduction after pulmonary vein isolation Europace, April 1, 2009; 11(4): 400 - 401. [Full Text] [PDF]
|
|
|
|
 |
|
 K.-R. J. Chun, B. Schmidt, A. Metzner, R. Tilz, T. Zerm, I. Koster, A. Furnkranz, B. Koektuerk, M. Konstantinidou, M. Antz, et al. The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study Eur. Heart J., March 2, 2009; 30(6): 699 - 709. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Van Belle, P. Janse, D. Theuns, T. Szili-Torok, and L. Jordaens One year follow-up after cryoballoon isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation Europace, November 1, 2008; 10(11): 1271 - 1276. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Malmborg, S. Lonnerholm, and C. Blomstrom-Lundqvist Acute and clinical effects of cryoballoon pulmonary vein isolation in patients with symptomatic paroxysmal and persistent atrial fibrillation Europace, November 1, 2008; 10(11): 1277 - 1280. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Neumann, J. Vogt, B. Schumacher, A. Dorszewski, M. Kuniss, H. Neuser, K. Kurzidim, A. Berkowitsch, M. Koller, J. Heintze, et al. Circumferential Pulmonary Vein Isolation With the Cryoballoon Technique: Results From a Prospective 3-Center Study J. Am. Coll. Cardiol., July 22, 2008; 52(4): 273 - 278. [Abstract] [Full Text] [PDF]
|
|