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Catheter ablation of atrial fibrillation using 2nd-generation cryoballoon in congenital heart disease patients — significance of RF ablation of additional atrial macro-reentrant tachycardia

BACKGROUND: Prevalence of atrial fibrillation (AF) is increasing in adult patients with congenital heart disease (CHD). Experience using the cryoballoon to achieve pulmonary vein isolation (PVI) in adult CHD patients is limited. The aim of the present study was to assess the value of PVI by cryoball...

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Autores principales: Krause, Ulrich, Müller, Matthias J., Schneider, Heike E., Paul, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9640420/
https://www.ncbi.nlm.nih.gov/pubmed/35419671
http://dx.doi.org/10.1007/s10840-022-01213-0
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author Krause, Ulrich
Müller, Matthias J.
Schneider, Heike E.
Paul, Thomas
author_facet Krause, Ulrich
Müller, Matthias J.
Schneider, Heike E.
Paul, Thomas
author_sort Krause, Ulrich
collection PubMed
description BACKGROUND: Prevalence of atrial fibrillation (AF) is increasing in adult patients with congenital heart disease (CHD). Experience using the cryoballoon to achieve pulmonary vein isolation (PVI) in adult CHD patients is limited. The aim of the present study was to assess the value of PVI by cryoballoon in adult CHD patients and to evaluate the significance of additional radiofrequency (RF) ablation of atrial tachycardia (AT). PATIENTS AND METHODS: Prospective data analysis; all patients with CHD and AF and PVI using the cryoballoon from January 2017 through November 2021 were included. RESULTS: Nineteen patients with various types of CHD were included. Median age was 58 (IQR 47–63) years. A total of 12/19 (63%) patients had had RF ablation of right atrial AT before. Median procedure duration was 225 (IQR 196–261) min. Median fluoroscopy time was 12.3 (IQR 5.2–19.5) min and median freeze time was 32 (IQR 28–36.3) min. Procedural success was achieved in all patients. Additional RF catheter ablation of intraatrial reentrant tachycardia within the left atrium was performed in 3/19 (16%) subjects and within the right atrium in 6/19 (32%) patients. Median follow-up was 26 (IQR 9–49) months. Excluding a 90-day blanking period, recurrence of AF was observed in 6/19 subjects (32%). After one redo procedure deploying RF energy only, 84% of all patients remained free from recurrence. Phrenic nerve palsy was observed in 1 subject. CONCLUSION: Results after PVI using the cryoballoon plus additional RF ablation of AT were promising (84% success including one redo procedure). Success of AF ablation was unsatisfactory in all patients who had no additional AT ablation. Ablation of any AT in these patients should therefore be considered in addition to PVI.
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spelling pubmed-96404202022-11-15 Catheter ablation of atrial fibrillation using 2nd-generation cryoballoon in congenital heart disease patients — significance of RF ablation of additional atrial macro-reentrant tachycardia Krause, Ulrich Müller, Matthias J. Schneider, Heike E. Paul, Thomas J Interv Card Electrophysiol Article BACKGROUND: Prevalence of atrial fibrillation (AF) is increasing in adult patients with congenital heart disease (CHD). Experience using the cryoballoon to achieve pulmonary vein isolation (PVI) in adult CHD patients is limited. The aim of the present study was to assess the value of PVI by cryoballoon in adult CHD patients and to evaluate the significance of additional radiofrequency (RF) ablation of atrial tachycardia (AT). PATIENTS AND METHODS: Prospective data analysis; all patients with CHD and AF and PVI using the cryoballoon from January 2017 through November 2021 were included. RESULTS: Nineteen patients with various types of CHD were included. Median age was 58 (IQR 47–63) years. A total of 12/19 (63%) patients had had RF ablation of right atrial AT before. Median procedure duration was 225 (IQR 196–261) min. Median fluoroscopy time was 12.3 (IQR 5.2–19.5) min and median freeze time was 32 (IQR 28–36.3) min. Procedural success was achieved in all patients. Additional RF catheter ablation of intraatrial reentrant tachycardia within the left atrium was performed in 3/19 (16%) subjects and within the right atrium in 6/19 (32%) patients. Median follow-up was 26 (IQR 9–49) months. Excluding a 90-day blanking period, recurrence of AF was observed in 6/19 subjects (32%). After one redo procedure deploying RF energy only, 84% of all patients remained free from recurrence. Phrenic nerve palsy was observed in 1 subject. CONCLUSION: Results after PVI using the cryoballoon plus additional RF ablation of AT were promising (84% success including one redo procedure). Success of AF ablation was unsatisfactory in all patients who had no additional AT ablation. Ablation of any AT in these patients should therefore be considered in addition to PVI. Springer US 2022-04-13 2022 /pmc/articles/PMC9640420/ /pubmed/35419671 http://dx.doi.org/10.1007/s10840-022-01213-0 Text en © The Author(s) 2022 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
Krause, Ulrich
Müller, Matthias J.
Schneider, Heike E.
Paul, Thomas
Catheter ablation of atrial fibrillation using 2nd-generation cryoballoon in congenital heart disease patients — significance of RF ablation of additional atrial macro-reentrant tachycardia
title Catheter ablation of atrial fibrillation using 2nd-generation cryoballoon in congenital heart disease patients — significance of RF ablation of additional atrial macro-reentrant tachycardia
title_full Catheter ablation of atrial fibrillation using 2nd-generation cryoballoon in congenital heart disease patients — significance of RF ablation of additional atrial macro-reentrant tachycardia
title_fullStr Catheter ablation of atrial fibrillation using 2nd-generation cryoballoon in congenital heart disease patients — significance of RF ablation of additional atrial macro-reentrant tachycardia
title_full_unstemmed Catheter ablation of atrial fibrillation using 2nd-generation cryoballoon in congenital heart disease patients — significance of RF ablation of additional atrial macro-reentrant tachycardia
title_short Catheter ablation of atrial fibrillation using 2nd-generation cryoballoon in congenital heart disease patients — significance of RF ablation of additional atrial macro-reentrant tachycardia
title_sort catheter ablation of atrial fibrillation using 2nd-generation cryoballoon in congenital heart disease patients — significance of rf ablation of additional atrial macro-reentrant tachycardia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9640420/
https://www.ncbi.nlm.nih.gov/pubmed/35419671
http://dx.doi.org/10.1007/s10840-022-01213-0
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