Occlusion tool software for pulmonary vein occlusion verification in atrial fibrillation cryoballoon ablation to avoid the use of contrast injection

Cauti, Filippo Maria; Rossi, Pietro; Polselli, Marco; Iaia, Luigi; Giannitti, Carlo Maria; Bianchi, Stefano

doi:10.1016/j.hrcr.2020.05.011

Cited by 13 publications

(20 citation statements)

References 5 publications

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“…In recent years, a novel imaging and navigation system, the KODEX-EPD (EPD Solutions, Philips, Best, The Netherlands), has been used in CBA procedure. It gives a good three-dimensional image of cardiac structure and also allows to assess the real-time PV occlusion, reducing the use of fluoroscopy and contrast injection ( 14 ). In the future, the advantages of CBA in AF treatment will become more prominent with help of these new devices and systems.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Using Second-Generation Cryoballoon and Radiofrequency Catheter for Atrial Fibrillation Ablation in Patients With the Common Ostium of Inferior Pulmonary Veins

Xie

Sun

et al. 2022

Front. Cardiovasc. Med.

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Aims: To compare the procedural outcomes of cryoballoon ablation (CBA) and radiofrequency ablation (RFA) in atrial fibrillation (AF) patients with the common ostium of inferior pulmonary veins (COIPV) and to explore the effect of COIPV on CBA performance through the assessment of anatomical factors.Methods: A total of 18 AF patients with COIPV were included. Pulmonary vein isolation (PVI) was performed with second-generation CBA or RFA. The anatomical characteristics of COIPV and procedural outcomes were collected.Results: The prevalence of COIPV was 0.82% in the enrolled population. PVI was achieved in all pulmonary veins (PVs) without any complications. The “tricircle” strategy was applied for RFA, and the segmental freeze strategy was performed for CBA. Compared with RFA, CBA had shorter procedural time (median: 53.0 vs. 78.0 min, p < 0.001) and longer fluoroscopy time (median: 13.5 vs. 6.0 min, p < 0.001). Higher ovality index of the ostium was seen in patients with ≥4 freezes in inferior PVs [IPVs; 0.95 (0.78–1.05) vs. 0.49 (0.21–0.83), p = 0.047]. During a median of 23.5 months of follow-up, the atrial arrhythmias-free survival after the procedure was comparable between CBA and RFA (p = 0.729).Conclusion: The second-generation CBA is an efficient and safe alternative for RFA in AF patients with COIPV. Anatomical characteristics of COIPV bring the challenge to the procedure performance of RFA and CBA.

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Section: Discussionmentioning

confidence: 99%

Comparison of Using Second-Generation Cryoballoon and Radiofrequency Catheter for Atrial Fibrillation Ablation in Patients With the Common Ostium of Inferior Pulmonary Veins

Xie

Sun

et al. 2022

Front. Cardiovasc. Med.

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“…Those features can improve the procedural efficiency. The previous studies showed the feasibility of using the KODEX-EPD system in radiofrequency or cryoballoon ablation in clinical practice (14,(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Novel Wide-Band Dielectric Imaging System Guided Lead Deployment for His Bundle Pacing: A Feasibility Study

Hua

Liu

et al. 2021

Front. Cardiovasc. Med.

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Introduction: His bundle pacing (HBP) is the most widely used physiological pacing modality, but difficulties in locating the His bundle lead to high fluoroscopic exposure. An electroanatomical mapping (EAM) system can be an efficient tool to achieve HBP implantation with near-zero fluoroscopic visualization.Methods: In the study, 20 patients who had indications for pacemaker implantation were prospectively enrolled and underwent HBP implantation either with the conventional fluoroscopy approach (the standard group) or guided by a novel KODEX-EPD mapping system (the EAM-guided group). The success rate, procedural details, pacing parameters, and procedure-related complications were compared between the two groups.Results: In the study, 20 consecutive patients were randomized with 10 patients in each group. HBP was successfully achieved in nine patients in the standard group and nine patients in the EAM-guided group. The procedural time was similar between the EAM-guided group vs. the standard group (85.40 ± 22.34 vs. 86.50 ± 15.05 min, p = 0.90). In comparison with the standard group, the EAM-guided group had a significant shorter total fluoroscopic time (FT) (1.45 ± 0.58 vs. 12.36 ± 5.46 min, p < 0.01) and His lead fluoroscopic time (HL-FT) (0.84 ± 0.56 vs. 9.27 ± 5.44 min, p < 0.01), while lower total fluoroscopic dose (3.13 ± 1.24 vs. 25.38 ± 11.15 mGy, p < 0.01) and His lead fluoroscopic dose (1.85 ± 1.17 vs. 19.06 ± 11.03 mGy, p < 0.01). No significant differences were observed in paced QRS duration and pacing parameters between the two groups. During a 3-month follow-up, one patient had a capture threshold increased >1 V/1.0 ms in the standard group, while no other complications were recorded in either group.Conclusion: The KODEX-EPD system could facilitate HBP implantation with significantly reduced FT and dose without compromising the procedural time.

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“…Additional mapping can be used to acquire more anatomical details and is done by roving the catheter within the cardiac chamber. Typically, several minutes of noncontact mapping may generate an accurate anatomical map of the right or left atrium 13,14 . These anatomical maps seem to correlate well with fluoroscopic images, and the high resolution of these maps results in many anatomic details that mimic a computed tomography‐like appearance 14 .…”

Section: Technology and Current Statementioning

confidence: 99%

Dielectric imaging for electrophysiology procedures: The technology, current state, and future potential

Abeln

Broek

Dijk

et al. 2021

Cardiovasc electrophysiol

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Electroanatomic mapping systems have become an essential tool to guide the identification and ablation of arrhythmic substrate. Recently, a novel guiding system for electrophysiology procedures was introduced that uses dielectric sensing to perform high resolution anatomical imaging. Dielectric imaging systems use electrical fields to differentiate anatomic structures based on their conductivity and permittivity. This technique enables non‐fluoroscopic, noncontact mapping of anatomic structures, assessment of pulmonary vein occlusion state during cryoballoon ablation, and has the potential to assess for additional tissue characterization including tissue thickness and tissue type. This article elaborates on the functioning and potential of dielectric imaging systems and provides two cases to illustrate the clinical impact for electrophysiology procedures.

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Occlusion tool software for pulmonary vein occlusion verification in atrial fibrillation cryoballoon ablation to avoid the use of contrast injection

Cited by 13 publications

References 5 publications

Comparison of Using Second-Generation Cryoballoon and Radiofrequency Catheter for Atrial Fibrillation Ablation in Patients With the Common Ostium of Inferior Pulmonary Veins

Comparison of Using Second-Generation Cryoballoon and Radiofrequency Catheter for Atrial Fibrillation Ablation in Patients With the Common Ostium of Inferior Pulmonary Veins

Novel Wide-Band Dielectric Imaging System Guided Lead Deployment for His Bundle Pacing: A Feasibility Study

Dielectric imaging for electrophysiology procedures: The technology, current state, and future potential

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