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Contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of PVs including carina-
PURPOSE: Compared with conventional pulmonary vein isolation (PVI) with radiofrequency ablation, PVI with cryoballoon is an easier and shorter procedure without reconnection, particularly in the superior pulmonary vein. However, the durability of the cryoballoon may be reduced due to anatomical fact...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9399060/ https://www.ncbi.nlm.nih.gov/pubmed/34435295 http://dx.doi.org/10.1007/s10840-021-01052-5 |
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author | Sakamoto, Yusuke Osanai, Hiroyuki Tanaka, Yuki Hiramatsu, Shotaro Matsumoto, Hikari Tagahara, Kensuke Hosono, Hirotaka Miyamoto, Shun Kondo, Shun Kanbara, Takahiro Nakashima, Yoshihito Asano, Hiroshi Ajioka, Masayoshi |
author_facet | Sakamoto, Yusuke Osanai, Hiroyuki Tanaka, Yuki Hiramatsu, Shotaro Matsumoto, Hikari Tagahara, Kensuke Hosono, Hirotaka Miyamoto, Shun Kondo, Shun Kanbara, Takahiro Nakashima, Yoshihito Asano, Hiroshi Ajioka, Masayoshi |
author_sort | Sakamoto, Yusuke |
collection | PubMed |
description | PURPOSE: Compared with conventional pulmonary vein isolation (PVI) with radiofrequency ablation, PVI with cryoballoon is an easier and shorter procedure without reconnection, particularly in the superior pulmonary vein. However, the durability of the cryoballoon may be reduced due to anatomical factors and the position of the pulmonary vein (PV). Further, inadequate isolation of the carina leads to recurrence of atrial fibrillation (AF). We aimed to determine whether using contrast-enhanced computed tomography (CT) for patient selection improves the early success rate and prevents the recurrence of AF in PVI with cryoballoon. METHODS: We evaluated patients who underwent ablation for paroxysmal atrial fibrillation in our hospital between July 2019 and November 2020. After excluding patients with contraindications for cryoablation, 50 patients were selected through visual inspection of the results of preoperative contrast-enhanced CT. A treatment plan was established, and the clinical course and outcomes were followed up. RESULTS: Of the 200 PVs of the 50 patients, only 8 PVs (4%) were incompletely isolated with a single cryoablation. Six of the eight PVs were successfully isolated with additional cryoablation. Only 2 patients (4%) underwent additional PVI with radiofrequency ablation. Four patients had AF recurrence within a mean follow-up period of 14.3 ± 5.1 months. The rate of sinus rhythm maintenance was 92%. PV reconnection was observed in 2 patients. None of the patients had postoperative atrial flutter. CONCLUSIONS: Selecting patients for cryoablation according to contrast-enhanced CT findings made the procedure easier to perform, leading to improved early success rates and clinical course. |
format | Online Article Text |
id | pubmed-9399060 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-93990602022-08-25 Contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of PVs including carina- Sakamoto, Yusuke Osanai, Hiroyuki Tanaka, Yuki Hiramatsu, Shotaro Matsumoto, Hikari Tagahara, Kensuke Hosono, Hirotaka Miyamoto, Shun Kondo, Shun Kanbara, Takahiro Nakashima, Yoshihito Asano, Hiroshi Ajioka, Masayoshi J Interv Card Electrophysiol Article PURPOSE: Compared with conventional pulmonary vein isolation (PVI) with radiofrequency ablation, PVI with cryoballoon is an easier and shorter procedure without reconnection, particularly in the superior pulmonary vein. However, the durability of the cryoballoon may be reduced due to anatomical factors and the position of the pulmonary vein (PV). Further, inadequate isolation of the carina leads to recurrence of atrial fibrillation (AF). We aimed to determine whether using contrast-enhanced computed tomography (CT) for patient selection improves the early success rate and prevents the recurrence of AF in PVI with cryoballoon. METHODS: We evaluated patients who underwent ablation for paroxysmal atrial fibrillation in our hospital between July 2019 and November 2020. After excluding patients with contraindications for cryoablation, 50 patients were selected through visual inspection of the results of preoperative contrast-enhanced CT. A treatment plan was established, and the clinical course and outcomes were followed up. RESULTS: Of the 200 PVs of the 50 patients, only 8 PVs (4%) were incompletely isolated with a single cryoablation. Six of the eight PVs were successfully isolated with additional cryoablation. Only 2 patients (4%) underwent additional PVI with radiofrequency ablation. Four patients had AF recurrence within a mean follow-up period of 14.3 ± 5.1 months. The rate of sinus rhythm maintenance was 92%. PV reconnection was observed in 2 patients. None of the patients had postoperative atrial flutter. CONCLUSIONS: Selecting patients for cryoablation according to contrast-enhanced CT findings made the procedure easier to perform, leading to improved early success rates and clinical course. Springer US 2021-08-25 2022 /pmc/articles/PMC9399060/ /pubmed/34435295 http://dx.doi.org/10.1007/s10840-021-01052-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Sakamoto, Yusuke Osanai, Hiroyuki Tanaka, Yuki Hiramatsu, Shotaro Matsumoto, Hikari Tagahara, Kensuke Hosono, Hirotaka Miyamoto, Shun Kondo, Shun Kanbara, Takahiro Nakashima, Yoshihito Asano, Hiroshi Ajioka, Masayoshi Contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of PVs including carina- |
title | Contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of PVs including carina- |
title_full | Contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of PVs including carina- |
title_fullStr | Contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of PVs including carina- |
title_full_unstemmed | Contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of PVs including carina- |
title_short | Contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of PVs including carina- |
title_sort | contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of pvs including carina- |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9399060/ https://www.ncbi.nlm.nih.gov/pubmed/34435295 http://dx.doi.org/10.1007/s10840-021-01052-5 |
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