Abstract:
BACKGROUND:Asymptomatic cerebral embolism (ACE) is sometimes detected after cryoballoon ablation of atrial fibrillation. The removal of air bubbles from the cryoballoon before utilization may reduce the rate of ACE. OBJECTIVE:This study aims to compare the incidence of ACE between a conventional and a novel balloon massaging method during cryoballoon ablation. METHODS:Of 175 consecutive patients undergoing initial cryoballoon ablation of paroxysmal atrial fibrillation, 60 (34.3%) patients underwent novel balloon massaging with extracorporeal balloon inflation in saline water (group N) before the cryoballoon was inserted into the body. The remaining 115 (65.7%) patients underwent conventional balloon massaging in saline water while the balloon remained folded (group C). Of those, 86 propensity score-matched patients were included. RESULTS:The baseline characteristics were similar between the 2 groups. In group N, even after balloon massaging in saline water was carefully performed, multiple air bubbles remained on the balloon surface when the cryoballoon was inflated in all cases. Postprocedural cerebral magnetic resonance imaging detected ACE in 14.0% of all patients. The incidence of ACE was significantly lower in group N than in group C (4.7% vs 23.3%; P = .01). According to multivariable analysis, the novel method was the sole factor associated with the presence of ACE (odds ratio 0.161; 95% confidence interval 0.033-0.736; P = .02). CONCLUSION:Preliminary removal of air bubbles in heparinized saline water with extracorporeal balloon inflation reduced the incidence of ACE. Since conventional balloon massaging failed to remove air bubbles completely, this novel balloon massaging method should be recommended before cryoballoon utilization.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Tokuda M,Matsuo S,Kato M,Sato H,Oseto H,Okajima E,Ikewaki H,Isogai R,Tokutake K,Yokoyama K,Narui R,Tanigawa SI,Yamashita S,Inada K,Yoshimura M,Yamane Tdoi
10.1016/j.hrthm.2017.05.035subject
Has Abstractpub_date
2017-09-01 00:00:00pages
1291-1296issue
9eissn
1547-5271issn
1556-3871pii
S1547-5271(17)30649-5journal_volume
14pub_type
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