Cryoballoon Ablation for Patients With Paroxysmal Atrial Fibrillation

Abstract

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice and induces cardiac dysfunction and stroke. The development of AF requires a trigger and also an electroanatomic substrate capable of both initiating and perpetuating AF. In the past decade, ectopic beats originating from the pulmonary veins (PV) have been identified as a source of paroxysmal AF. Thus, strategies that target the PV, including the PV antrum, are the cornerstone of most AF ablation procedures. Recently, alternative technologies to radiofrequency catheter ablation for paroxysmal AF such as balloon ablation modalities have been developed. The purpose of this review is to discuss cryoballoon ablation for paroxysmal AF.

New Minimally Invasive and Tailor-Made Strategy for Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation

“…Aryana et al tested a dosing protocol guided exclusively by the TTI in 355 patients compared with 400 control patients who underwent a CBA using a conventional approach [29]. Although the current study observed the PV potentials in 32% of the PVs during the CBA procedure, the fourth-generation CB enabled better observation of the PV potentials with its shorter balloon tip than the second-generation CB [19]. In the future, the best strategy may be created by combining the TTT with TTI.…”

“…The detailed CBA methodology was previously reported [19]. In brief, general anaesthesia (laryngeal mask airway, I-gel device, Intersurgical Inc., Wokingham, Berkshire, UK) under administration of propofol and dexmedetomidine was employed, with oesophageal temperature monitoring using a multi-thermocouple temperature probe (SensiTherm, St. Jude Medical, Maple Grove, MN, USA).…”