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Time to −30°C as a predictor of acute success during cryoablation in patients with atrial fibrillation

BACKGROUND: Freezing rate of second-generation cryoballoon (CB) is a biophysical parameter that could assist pulmonary vein isolation. The aim of this study is to assess freezing rate (time to reach −30°C ([TT-30C]) as an early predictor of acute pulmonary vein isolation using the CB. METHODS: Bioph...

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Autores principales: Álvarez-Ortega, Carlos Antonio, Ruiz, Miguel Angel, Solórzano-Guillén, César, Barrera, Alberto, Toquero-Ramos, Jorge, Martínez-Alday, Jesús Daniel, Grande, Carlos, Segura, José Maria, García-Alberola, Arcadio, Moriña-Vázquez, Pablo, Ferrero-de-Loma-Osorio, Ángel, Villuendas, Roger, Cózar, Rocío, Arcocha, Maria Fe, Ibañez, Alicia, Peinado, Rafael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Via Medica 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10508066/
https://www.ncbi.nlm.nih.gov/pubmed/34708863
http://dx.doi.org/10.5603/CJ.a2021.0135
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author Álvarez-Ortega, Carlos Antonio
Ruiz, Miguel Angel
Solórzano-Guillén, César
Barrera, Alberto
Toquero-Ramos, Jorge
Martínez-Alday, Jesús Daniel
Grande, Carlos
Segura, José Maria
García-Alberola, Arcadio
Moriña-Vázquez, Pablo
Ferrero-de-Loma-Osorio, Ángel
Villuendas, Roger
Cózar, Rocío
Arcocha, Maria Fe
Ibañez, Alicia
Peinado, Rafael
author_facet Álvarez-Ortega, Carlos Antonio
Ruiz, Miguel Angel
Solórzano-Guillén, César
Barrera, Alberto
Toquero-Ramos, Jorge
Martínez-Alday, Jesús Daniel
Grande, Carlos
Segura, José Maria
García-Alberola, Arcadio
Moriña-Vázquez, Pablo
Ferrero-de-Loma-Osorio, Ángel
Villuendas, Roger
Cózar, Rocío
Arcocha, Maria Fe
Ibañez, Alicia
Peinado, Rafael
author_sort Álvarez-Ortega, Carlos Antonio
collection PubMed
description BACKGROUND: Freezing rate of second-generation cryoballoon (CB) is a biophysical parameter that could assist pulmonary vein isolation. The aim of this study is to assess freezing rate (time to reach −30°C ([TT-30C]) as an early predictor of acute pulmonary vein isolation using the CB. METHODS: Biophysical data from CB freeze applications within a multicenter, nation-wide CB ablation registry were gathered. Successful application (SA), was defined as achieving durable intraprocedural vein isolation. And SA with time to isolation under 60 s (SA-TTI<60) as achieving durable vein isolation in under 60 s. Logistic regressions were performed and predictive models were built for the data set. RESULTS: 12,488 CB applications from 1,733 atrial fibrillation (AF) ablation procedures were included within 27 centers from a Spanish CB AF ablation registry. SA was achieved in 6,349 of 9,178 (69.2%) total freeze applications, and SA-TTI<60 was obtained in 2,673 of 4,784 (55.9%) freezes where electrogram monitoring was present. TT-30C was shorter in the SA group (33.4 ± 9.2 vs 39.3 ± 12.1 s; p < 0.001) and SA-TTI<60 group (31.8 ± 7.6 vs. 38.5 ± 11.5 s; p < 0.001). Also, a 10 s increase in TT-30C was associated with a 41% reduction in the odds for an SA (odds ratio [OR] 0.59; 95% confidence interval [CI] 0.56–0.63) and a 57% reduction in the odds for achieving SA-TTI<60 (OR 0.43; 95% CI 0.39–0.49), when corrected for electrogram visualization, vein position, and application order. CONCLUSIONS: Time to reach −30°C is an early predictor of the quality of a CB application and can be used to guide the ablation procedure even in the absence of electrogram monitoring.
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spelling pubmed-105080662023-09-20 Time to −30°C as a predictor of acute success during cryoablation in patients with atrial fibrillation Álvarez-Ortega, Carlos Antonio Ruiz, Miguel Angel Solórzano-Guillén, César Barrera, Alberto Toquero-Ramos, Jorge Martínez-Alday, Jesús Daniel Grande, Carlos Segura, José Maria García-Alberola, Arcadio Moriña-Vázquez, Pablo Ferrero-de-Loma-Osorio, Ángel Villuendas, Roger Cózar, Rocío Arcocha, Maria Fe Ibañez, Alicia Peinado, Rafael Cardiol J Interventional Cardiology BACKGROUND: Freezing rate of second-generation cryoballoon (CB) is a biophysical parameter that could assist pulmonary vein isolation. The aim of this study is to assess freezing rate (time to reach −30°C ([TT-30C]) as an early predictor of acute pulmonary vein isolation using the CB. METHODS: Biophysical data from CB freeze applications within a multicenter, nation-wide CB ablation registry were gathered. Successful application (SA), was defined as achieving durable intraprocedural vein isolation. And SA with time to isolation under 60 s (SA-TTI<60) as achieving durable vein isolation in under 60 s. Logistic regressions were performed and predictive models were built for the data set. RESULTS: 12,488 CB applications from 1,733 atrial fibrillation (AF) ablation procedures were included within 27 centers from a Spanish CB AF ablation registry. SA was achieved in 6,349 of 9,178 (69.2%) total freeze applications, and SA-TTI<60 was obtained in 2,673 of 4,784 (55.9%) freezes where electrogram monitoring was present. TT-30C was shorter in the SA group (33.4 ± 9.2 vs 39.3 ± 12.1 s; p < 0.001) and SA-TTI<60 group (31.8 ± 7.6 vs. 38.5 ± 11.5 s; p < 0.001). Also, a 10 s increase in TT-30C was associated with a 41% reduction in the odds for an SA (odds ratio [OR] 0.59; 95% confidence interval [CI] 0.56–0.63) and a 57% reduction in the odds for achieving SA-TTI<60 (OR 0.43; 95% CI 0.39–0.49), when corrected for electrogram visualization, vein position, and application order. CONCLUSIONS: Time to reach −30°C is an early predictor of the quality of a CB application and can be used to guide the ablation procedure even in the absence of electrogram monitoring. Via Medica 2023-08-31 /pmc/articles/PMC10508066/ /pubmed/34708863 http://dx.doi.org/10.5603/CJ.a2021.0135 Text en Copyright © 2023 Via Medica https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially
spellingShingle Interventional Cardiology
Álvarez-Ortega, Carlos Antonio
Ruiz, Miguel Angel
Solórzano-Guillén, César
Barrera, Alberto
Toquero-Ramos, Jorge
Martínez-Alday, Jesús Daniel
Grande, Carlos
Segura, José Maria
García-Alberola, Arcadio
Moriña-Vázquez, Pablo
Ferrero-de-Loma-Osorio, Ángel
Villuendas, Roger
Cózar, Rocío
Arcocha, Maria Fe
Ibañez, Alicia
Peinado, Rafael
Time to −30°C as a predictor of acute success during cryoablation in patients with atrial fibrillation
title Time to −30°C as a predictor of acute success during cryoablation in patients with atrial fibrillation
title_full Time to −30°C as a predictor of acute success during cryoablation in patients with atrial fibrillation
title_fullStr Time to −30°C as a predictor of acute success during cryoablation in patients with atrial fibrillation
title_full_unstemmed Time to −30°C as a predictor of acute success during cryoablation in patients with atrial fibrillation
title_short Time to −30°C as a predictor of acute success during cryoablation in patients with atrial fibrillation
title_sort time to −30°c as a predictor of acute success during cryoablation in patients with atrial fibrillation
topic Interventional Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10508066/
https://www.ncbi.nlm.nih.gov/pubmed/34708863
http://dx.doi.org/10.5603/CJ.a2021.0135
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