Electro-anatomical mapping of the left atrium before and after cryothermal balloon isolation of the pulmonary veins
Open Access
- 16 January 2009
- journal article
- clinical trial
- Published by Springer Science and Business Media LLC in Journal of Interventional Cardiac Electrophysiology
- Vol. 25 (1), 59-65
- https://doi.org/10.1007/s10840-008-9344-9
Abstract
The 28 mm cryoballoon catheter is a device used for pulmonary vein isolation (PVI). The aim of this study was to evaluate the extent of the ablation in the antral regions of the left atrium. Eighteen patients with drug refractory, symptomatic, paroxysmal AF were enrolled. A 3D electroanatomic reconstruction of the left atrium was made before and after successful PVI with the 28 mm cryoballoon. Markers were placed at the ostium. Sixteen patients were mapped. Fourteen patients had 4 veins each, and 2 patients had a common ostium of the left sided veins. All separate ostia were isolated in the antral region. The two common ostia showed ostial isolation. There was a significant difference in vein size between the common (29 and 31 mm) and the separate ostia (19 ± 4 mm) (p < 0.01). The performance of an additional segmental ablation if balloon PVI did not eliminate all electrical activity, did not influence the extent of the ablation. The earliest left atrial activation during sinus rhythm was located in the superior septal region before ablation in all patients. After ablation, two patients showed a substantial downward shift towards the middle and inferior septal region respectively (NS). Four patients demonstrated a slight downward shift of the first activation. In cryoballoon PVI, the majority of the veins undergo antral isolation. Veins with a diameter larger than the balloon, are isolated ostially. In individual cases, the left atrial activation sequence appears to be altered after ablation.Keywords
This publication has 12 references indexed in Scilit:
- Balloon catheter ablation to treat paroxysmal atrial fibrillation: What is the level of pulmonary venous isolation?Heart Rhythm, 2008
- Efficacy of Adjuvant Anterior Left Atrial Ablation During Intracardiac Echocardiography‐Guided Pulmonary Vein Antrum Isolation for Atrial FibrillationJournal of Cardiovascular Electrophysiology, 2006
- The Bachmann Bundle and Interatrial ConductionCardiology in Review, 2006
- Cryoablation of the pulmonary veins using a novel balloon catheterJournal of Interventional Cardiac Electrophysiology, 2006
- Efficacy and Safety of Circumferential Pulmonary Vein Isolation Using a Novel Cryothermal Balloon Ablation SystemJournal of the American College of Cardiology, 2005
- Ablation of Atrial-Ventricular Junction Tissues via the Coronary Sinus Using Cryo Balloon TechnologyJournal of Interventional Cardiac Electrophysiology, 2005
- Transvenous Catheter Cryoablation for Treatment of Atrial Fibrillation:Pacing and Clinical Electrophysiology, 2005
- Percutaneous Pulmonary Vein Cryoablation to Treat Atrial FibrillationJournal of Interventional Cardiac Electrophysiology, 2004
- The safety and efficacy of multiple consecutive cryo lesions in canine pulmonary veins-left atrial junctionHeart Rhythm, 2004
- Pulmonary vein isolation using transvenous catheter cryoablation for treatment of atrial fibrillation without risk of pulmonary vein stenosisJournal of the American College of Cardiology, 2003