Re: CT imaging of complications of catheter ablation for atrial fibrillation

Kumar, Narendra; Timmermans, Carl; Das, Marco; Pison, Laurent; Crijns, Hjgm

doi:10.1016/j.crad.2014.04.009

Cited by 7 publications

(6 citation statements)

References 10 publications

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“…The monolateral approach, compared to the bilateral approach, reduces risk of complications as bleeding, pneumothorax, and lung hernia [57, 58] and is supposed to be less painful, improving the patient’s recovery. It is preferred in patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

Hybrid ablation for atrial fibrillation: a systematic review

Vroomen

Pison

2016

J Interv Card Electrophysiol

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PurposeHybrid ablation for AF is performed in a growing number of centers. Due to absence of guidelines, operative approaches and perioperative care differ per center. In this review, an overview of findings from published studies on hybrid ablations is given, and related topics are discussed (e.g., one- and two-stage approaches, lesion sets, and patient management).MethodsA systematic literature search was performed in the PubMed and Embase databases. All identified articles were screened and checked for eligibility by the two authors.ResultsTwelve studies describing a total of 563 patients were selected. Due to substantial differences in approaches (one-stage, two-stage, sequential), surgical techniques (bilateral or monolateral thoracoscopy, subxiphoideal, transabdominal), energy sources (unipolar, bipolar), lesion sets (applying left or right atrial lesions), periprocedural care and endpoints (monitoring, definition of recurrence), and success rates (sinus rhythm after a mean of 26 months) are difficult to compare and varied from 27 % (without antiarrhythmic drugs, AADs) to 94 % (with AADs). For studies using bipolar devices, success rates with the use of antiarrhythmic drugs were at least 71 %. Major complications such as bleeding, sternotomy, and death occurred in 7 % of the total population (of which ten complications, 16 %, occurred in the concomitant cardiac surgery hybrid group).ConclusionThe field of AF ablation has dramatically changed over the past years, with one of the most recent developments the hybrid AF ablation. Lack of matching data hinders drawing conclusions and creating guidelines. Early results however are encouraging. More data are awaiting and needed.

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Section: Discussionmentioning

confidence: 99%

Hybrid ablation for atrial fibrillation: a systematic review

Vroomen

Pison

2016

J Interv Card Electrophysiol

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“…Th e intensity of ground glass opacifi cation is also related to the temporal delay of CT scan. 7 Furthermore, right superior PVs showed ostial in duration in two patients. Hyperemic mucosa and erosion were discovered using bronchoscopy in two patients.…”

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confidence: 94%

Hemoptysis After Cryoablation for Atrial Fibrillation

Kumar

Timmermans

Das

et al. 2014

Chest

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“…One patient had recurrent pain in the left thorax region a few weeks after the procedure. Diagnosis of atraumatic lung hernia was confirmed by high-resolution computerised tomographic (HRCT) [ 9 , 10 ]. Retrospectively, the aetiology was attributed to widening of the mini invasions of 12 mms (initially) to 3 cm to accommodate an epicardial left atrial appendage (LAA) clip.…”

Section: Adverse Eventsmentioning

confidence: 99%

The symbiosis of contact force catheter use for hybrid ablation for atrial fibrillation

et al. 2015

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ObjectiveReconduction across an ablation line is a common reason for arrhythmia recurrence over time. The hybrid procedure combines epicardial ablation of the pulmonary vein (PV) and creation of a box lesion with endocardial touch-ups for any electrical gaps. A high contact force (CF) between the ablation tip and cardiac tissue may increase the risk of thrombus formation, catheter tip charring, steam pop formation, and even cardiac perforation. CF monitoring is a significant new parameter for titration of the CF for creating an adequate lesion.MethodsThirty-eight consecutive patients underwent epicardial ablation using bipolar radiofrequency devices. After checking electrical bidirectional block of the ablation lines, an endocardial CF catheter was used for further ablation (if needed) to complete the isolation of PVs, box lesion, cavotricuspid isthmus (CTI), and complex fractionated atrial electrograms (CFAE).ResultsEndocardial touch-up was needed for 2 PVs (1.3 %) and 10 (26.3 %) box lesions. It was also used for the CTI line in 7 (18.4 %) patients, atrial tachycardia in 3 (7.9 %) patients, and additional CFAE ablation in 17 (44.7 %) patients. All 5 patients with arrhythmia recurrence had a mean CF < 10 g (p = 0.03). Procedure duration was significantly shorter in the CF group (223 ± 57 vs. 256 ± 60 min, p = 0.03) compared with control group.ConclusionUse of CF catheters is safe, feasible, and complementary to a hybrid procedure setup for atrial fibrillation ablation. Its real-time monitoring may predict future arrhythmia recurrence, and decrease procedure time.

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Re: CT imaging of complications of catheter ablation for atrial fibrillation

Cited by 7 publications

References 10 publications

Hybrid ablation for atrial fibrillation: a systematic review

Hybrid ablation for atrial fibrillation: a systematic review

Hemoptysis After Cryoablation for Atrial Fibrillation

The symbiosis of contact force catheter use for hybrid ablation for atrial fibrillation

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