A multicenter study of the need of additional freezing for cryoballoon ablation in patients with atrial fibrillation: The AD‐Balloon study

Miyamoto, Koji; Doi, Atsushi; Amaya, Naoki; Morita, Yoshiaki; Noda, Takashi; Asakura, Masanori; Hamasaki, Toshimitsu; Tada, Hiroshi; Takagi, Masahiko; Yasuda, Satoshi; Kusano, Kengo

doi:10.1016/j.joa.2016.06.005

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…If the LA–PV conduction persisted after cryoballoon ablation, we performed an additional touch‐up ablation using an open‐irrigated linear ablation catheter with a 3.5‐mm tip (Thermocool SmartTouch ™ ; Biosense Webster or FlexAbility ™ ; St. Jude Medical) via a FlexCath Advance ™ sheath or a Swartz Braided SL0 ™ Transseptal Guiding Introducer Sheath (St. Jude Medical). Radiofrequency energy was applied for 30 seconds at each site using a maximum temperature of 42°C, and maximum power of 35 W. PVI was confirmed using the 20‐pole circular catheter …”

Section: Methodsmentioning

confidence: 99%

A decapolar 25‐mm‐diameter circular mapping catheter with improved detection of pulmonary vein potential disappearance in cryoballoon ablation

Matsuda

Masuda

Asai

et al. 2019

Journal of Arrhythmia

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Background Disappearance of pulmonary vein ( PV ) potentials is an important indicator of successful PV isolation during cryoballoon ablation. Conventional octapolar 20‐mm‐diameter circular PV mapping catheters occasionally fail to identify persistent PV potentials. A new decapolar 25‐mm‐diameter circular PV mapping catheter has been introduced to improve the detection of PV potentials and their elimination. We compared the detection rates of PV potential disappearance between the decapolar and the octapolar PV mapping catheters. Methods and Results A total of 44 consecutive patients (175 PV s) undergoing initial cryoballoon ablation for atrial fibrillation were included. The decapolar catheter was used for 79 (45%) PV s in 20 (45%) patients. There was no difference in left atrial diameter or PV diameter in patients mapped with the two catheters. The decapolar mapping catheter demonstrated a significantly higher detection rate of PV potential disappearance than the octapolar catheter. The need for touch‐up ablation was similar between the two groups (5% vs 8%, P = 0.39). When PV potentials were identified, the decapolar catheter detected significantly higher‐amplitude PV potentials than the octapolar catheter. In multivariate analysis, use of the decapolar catheter was an independent predictor of the detection of PV potential disappearance. Conclusions The decapolar PV mapping catheter demonstrated improved detection of PV potential disappearance in cryoballoon PV isolation.

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Section: Methodsmentioning

confidence: 99%

A decapolar 25‐mm‐diameter circular mapping catheter with improved detection of pulmonary vein potential disappearance in cryoballoon ablation

Matsuda

Masuda

Asai

et al. 2019

Journal of Arrhythmia

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Multicenter Study of the Validity of Additional Freeze Cycles for Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation

Miyamoto

Doi

Hasegawa

et al. 2019

Circ: Arrhythmia and Electrophysiology

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Background: Pulmonary vein isolation (PVI) is a cornerstone of catheter ablation in patients with paroxysmal atrial fibrillation, and balloon-based ablation has been recently performed worldwide. The second-generation cryoballoon (CB2) ablation has proven to be highly effective in achieving freedom from paroxysmal atrial fibrillation. However, there are some debatable questions, including the ideal number of freeze cycles. Methods: The AD-Balloon study (Multicenter Study of the Validity of Additional Freeze Cycles for Cryoballoon Ablation) was designed as a prospective, multicenter, and randomized clinical trial for investigation of the optimal strategy of freeze cycles for the CB2 ablation. One hundred and ten consecutive patients (aged 64±11 years) were randomly assigned to 2 groups after achieving a PVI by the CB2 ablation: 3-minute freeze cycles were added to each pulmonary vein (AD group: n=55) or not (non-AD group: n=55). Delayed-enhancement magnetic resonance imaging was also performed 1 to 2 months after the PVI to assess the ablation lesions. Results: The patient characteristics did not differ between the 2 groups. A complete PVI was achieved in all patients. The total number of freeze cycles and durations for all pulmonary veins were significantly shorter in the non-AD group than in the AD group (5.7±1.6 versus 9.1±1.6 cycles, P <0.0001, and 932±244 versus 1483±252 seconds, P <0.0001). The cumulative freedom from any atrial tachyarrhythmia at 1 year was 87.3% in the AD group and 89.1% in the non-AD group (log-rank test P =0.78). There was no significant difference in the frequency of gaps on the PVI lines in the delayed-enhancement magnetic resonance imaging (46% in the AD group versus 36% in the non-AD group; P =0.38). Conclusions: No benefit was found in the patients receiving additional 3-minute freeze cycles after the complete PVI with the CB2 ablation, suggesting that an insurance freeze after achieving a PVI with the CB2 may be unnecessary and time consuming.

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A multicenter study of the need of additional freezing for cryoballoon ablation in patients with atrial fibrillation: The AD‐Balloon study

Cited by 2 publications

References 22 publications

A decapolar 25‐mm‐diameter circular mapping catheter with improved detection of pulmonary vein potential disappearance in cryoballoon ablation

A decapolar 25‐mm‐diameter circular mapping catheter with improved detection of pulmonary vein potential disappearance in cryoballoon ablation

Multicenter Study of the Validity of Additional Freeze Cycles for Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation

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