Abstract:
INTRODUCTION:Pulmonary vein isolation (PVI) is the cornerstone ablation strategy for treatment of atrial fibrillation (AF). Ablation outside the PVs is sometimes needed particularly in persistent or longstanding AF. This study reported left atrial appendage isolation (LAAI) using cryoballoon (CB) focusing on technical data and short-term clinical follow-up. METHODS AND RESULTS:Patients with recurrent persistent AF after multiple AF procedures were enrolled. LAAI was performed using the second generation CB guided by compound motor action potential (CMAP) and 240 seconds plus bonus freeze (ICE-B) protocol. Ten patients were included, median age was 69.5 (56-73) years, CHA2 DS 2 -VASc score was 3 (1.8-4), LA diameter was 44 (38.8-46.5) mm. All patients had a mean of three AF procedures before the LAAI procedure. All patients were under successful CMAP guidance. During the CB LAAI procedure, the median time to LAA isolation was 100 (76-270) seconds, minimal freeze temperature was -50 (-57 to -47)°C. A "pull-down (or pull-away)" CB maneuver was performed in all patients. Median fluoroscopic time was 4.8 (3.4-6.8) minutes and acute LAAI success rate was 100%. No phrenic nerve injury or other major complications were observed. At 6-week follow-up, remapping of the LAA showed durable isolation of all PVs (100%), all patients were scheduled for LAA occlusion. Six-month follow-up showed that 80% of patients were free from AF/AT recurrence. CONCLUSION:CMAP plus ICE-B guided LAAI using cryo-technology appears feasible and safe, results in durable LAAI, and shows promising clinical results in patients with recurrent persistent AF.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Chen S,Schmidt B,Bordignon S,Perrotta L,Bologna F,Nagase T,Chun KRJdoi
10.1111/jce.13818subject
Has Abstractpub_date
2019-02-01 00:00:00pages
272-283issue
2eissn
1045-3873issn
1540-8167journal_volume
30pub_type
杂志文章abstract:INTRODUCTION:Reversible esophageal thermal lesions after cryoballoon pulmonary vein isolation (CB-PVI) have been reported when using variable balloon sizes. The aim of this study was to investigate (1) the incidence of esophageal thermal lesions, and (2) esophageal temperature changes associated with CB-PVI using the s...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2010.01739.x
更新日期:2010-08-01 00:00:00
abstract:INTRODUCTION:Atrial arrhythmias, including atrial flutter, are common in orthotopic heart transplant recipients. However, only a small number of individual case reports describe the electrical circuit and catheter ablation of atrial flutter after heart transplantation. METHODS AND RESULTS:Detailed electrophysiologic e...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.04440.x
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to assess how well acute procedural outcomes predict the clinical outcome of catheter ablation of premature ventricular complexes (PVCs). METHODS:A consecutive series of 50 patients (28 women, age: 51 ± 13 years) with frequent PVCs was referred for PVC ablation. Acute failure w...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12400
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Contact-force (CF) sensing catheters are increasingly used in clinical electrophysiological practice due to their efficacy and safety profile. As data about the accuracy of this technology are scarce, we sought to quantify accuracy based on in vitro experiments. METHODS AND RESULTS:A custom-made force senso...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12886
更新日期:2016-03-01 00:00:00
abstract:INTRODUCTION:Sudden cardiac death is a substantial cause of mortality in patients with cardiomyopathy, but evidence supporting implantable cardioverter-defibrillator (ICD) implantation is less robust in nonischemic cardiomyopathy (NICM) than in ischemic cardiomyopathy. Improved risk stratification is needed. We assesse...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14395
更新日期:2020-05-01 00:00:00
abstract::We report a case in which endocardial radiofrequency (RF) ablation guided by unipolar intracoronary mapping using a guidewire was an effective therapy for treating VT originating from an epicardial site of the left ventricle. A 55-year-old man with dilated cardiomyopathy was referred for treatment of refractory sustai...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00357.x
更新日期:2006-06-01 00:00:00
abstract:INTRODUCTION:We investigated the spread of the excitation wave over the atria following initiation in a given focus in an atrial model containing its overall geometry only, i.e., without atrial bundles. METHODS AND RESULTS:The propagation velocity of the excitation wave was taken to be uniform, and the wall thickness ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540.8167.90307.x
更新日期:2003-10-01 00:00:00
abstract::Pulmonary vein (PV) arrhythmogenicity underlying the maintenance of atrial fibrillation (AF) may be explained by three mechanisms: enhanced automaticity, triggered activity, and reentry. There are only a few reports describing sustained PV tachycardias (PVT) following electrical disconnection from the left atrium, in ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00713.x
更新日期:2007-04-01 00:00:00
abstract::Atrial fibrillation (AF) and congestive heart failure (CHF) are two increasingly common cardiac disorders with a growing prevalence in the overall population. Improved treatment of acute medical conditions has increased the incidence of these cardiac disorders. AF and CHF have similar epidemiologic characteristics and...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1046/j.1540-8167.2002.00399.x
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is the most commonly encountered clinical arrhythmia, predominantly affecting elderly patients. There is a continued need for new antiarrhythmic drugs to treat the ever-increasing number of patients with this arrhythmia. Dronedarone is a new antiarrhythmic compound currently being de...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1540-8167.2007.01016.x
更新日期:2008-01-01 00:00:00
abstract::A case of intermittent sinus parasystole in which the parasystolic focus is protected from the dominant sinus rhythm only during the second half of its intrinsic cycle is reported. In addition, a modulating (i.e., electronic) effect is often clearly exerted from the dominant rhythm upon the focus during the protected ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1996.tb00523.x
更新日期:1996-03-01 00:00:00
abstract:INTRODUCTION:Syncope occasionally may occur in the supine patient due to severe brady- or tachyarrhythmia. However, recurrent syncope upon assumption of the supine position as a result of a neurally mediated reflex mechanism has not been reported previously. METHODS AND RESULTS:Two young patients, both of whom had sig...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00932.x
更新日期:1998-04-01 00:00:00
abstract:INTRODUCTION:The clinical role of atrial arrhythmias (AA) in arrhythmogenic right ventricular cardiomyopathy (ARVC) and the echocardiographic variables that predict them are not well defined. We describe the prevalence, types, echocardiographic predictors, and management of AA in patients with ARVC. METHODS:We retrosp...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/jce.14069
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:Patients with nonischemic cardiomyopathy (NICM) and ventricular tachycardia (VT) usually have basal-lateral scar in the left ventricle (LV). We sought to determine electrocardiogram (ECG) characteristics that may help identify NICM patients with basal-lateral scar and VT. METHODS AND RESULTS:Phase I, stud...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02129.x
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:Little data exists on the electrophysiological differences between sustained atrial fibrillation (sAF; >5 minutes) vs self-terminating nonsustained AF (nsAF; <5 minutes). We sought to investigate the electrophysiological characteristics of coronary sinus (CS) activity during postpulmonary vein isolation (P...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14296
更新日期:2020-01-01 00:00:00
abstract::Characterization of the substrate and mechanism of epicardial ventricular tachycardia (VT) associated with idiopathic nonischemic dilated cardiomyopathy is limited. We report a case of successful mapping and ablation of an epicardial VT by a percutaneous transthoracic approach in a patient with idiopathic dilated card...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.01164.x
更新日期:2002-11-01 00:00:00
abstract:INTRODUCTION:While atrial fibrillation (AF) initiation in the pulmonary veins has been well-studied, simultaneous biatrial and three-dimensional noncontact mapping (NCM) has not been performed. We hypothesized that these two techniques would provide novel information on triggers, initiation, and evolution of spontaneou...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.40531.x
更新日期:2005-05-01 00:00:00
abstract:INTRODUCTION:Following radiofrequency catheter ablation of AV nodal reentrant tachycardia (AVNRT), inappropriate sinus tachycardia may occur, possibly due to damage to autonomic cardiac nerve fibers. Furthermore, inducibility of AVNRT is often critically dependent on the autonomic balance. We investigated whether succe...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00936.x
更新日期:1998-06-01 00:00:00
abstract::Epicardial RFA to Achieve Electrical PV Isolation. During catheter ablation of atrial fibrillation, ablation within the pulmonary veins is undesirable due to the risk of pulmonary venous stenosis and the possibility of leaving residual cuffs of arrhythmogenic tissue proximal to the ablation lesion set. An extra-ostial...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2003.03049.x
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Repeated freezing (bonus applications) during cryoballoon pulmonary vein isolation (PVI) has been suggested to improve lesion durability. However, the long-term clinical effects of repeated freezing have not been investigated. METHODS AND RESULTS:A total of 51 patients (pts) with paroxysmal atrial fibrillat...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2012.02315.x
更新日期:2012-08-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to determine the characteristics of heart rate variability (HRV), blood pressure variability (BPV), and baroreflex gain (BRG) at rest and during orthostatic stress in patients with clinical criteria of inappropriate sinus tachycardia (IST). METHODS AND RESULTS:Beat-to-beat HRV an...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2005.04441.x
更新日期:2005-01-01 00:00:00
abstract::Patients with congenital heart disease have unique pacing challenges and often require epicardial systems. High pacing threshold is one of the major factors that decrease these systems' durability. Sometimes surgical reintervention or lead replacement is difficult or prohibitive in these patients due to repeated surge...
journal_title:Journal of cardiovascular electrophysiology
pub_type:
doi:10.1111/jce.14603
更新日期:2020-08-01 00:00:00
abstract:INTRODUCTION:Outflow tract ventricular arrhythmia (OTVA) can be complicated to target for ablation when originating from either the periaortic or pulmonary valve (PV) region. Both sites may present with a small R wave in lead V1. However, the utility of lead I in distinguishing these arrhythmia locations is unknown. M...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12330
更新日期:2014-04-01 00:00:00
abstract:INTRODUCTION:Several studies have shown that the fast pathway is more responsive to adenosine than the slow pathway in patients with AV nodal reentrant tachycardia. Little information is available regarding the effect of adenosine on anterograde and retrograde fast pathway conduction. METHODS AND RESULTS:The effects o...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00121.x
更新日期:1998-08-01 00:00:00
abstract:INTRODUCTION:The high posterolateral right atrium (RA) is considered the "sinus node area," but we lack information on endocardial atrial activation in sinus rhythm. We studied RA and left atrial (LA) endocardial activation in the electrophysiology laboratory. METHODS AND RESULTS:Thirty-five patients (21 men) aged 47 ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2004.03403.x
更新日期:2004-05-01 00:00:00
abstract::The use of multiple His bundle-right bundle branch recordings in electrophysiologic studies has facilitated definition of the mechanism and elucidation of the direction of impulse propagation in bundle branch reentrant tachycardia, "Mahaim" fiber reciprocating tachycardia, and retrograde His depolarization in fascicul...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1994.tb01172.x
更新日期:1994-04-01 00:00:00
abstract:INTRODUCTION:The current practice of percutaneous subxiphoid needle access to the "healthy" pericardial sac has significant limitations. We sought to examine the feasibility of a novel toolkit designed to improve this procedure. METHODS AND RESULTS:The toolkit included a pericardial access needle and a virtual imaging...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12643
更新日期:2015-05-01 00:00:00
abstract:INTRODUCTION:Data on long-term follow-up (LTFU) after interventional closure of the left atrial appendage (LAAC) in patients with nonvalvular atrial fibrillation (AF) are scarce. We sought to determine the outcome of patients after LAAC with the first generation device. METHODS AND RESULTS:The Cardioangiologisches Cen...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12704
更新日期:2015-08-01 00:00:00
abstract::This article reviews current evidence of non-antiarrhythmic agents for the prevention and maintenance of sinus rhythm in patients with atrial fibrillation. These nontraditional agents include angiotensin converting enzyme inhibitors, angiotensin receptor blockers, antiinflammatory agents, calcium channel blockers, and...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2007.00874.x
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Noninducibility of sustained atrial fibrillation (AF) after pulmonary vein isolation (PVI) has been shown to be associated with a better clinical outcome. We evaluated the role of clinical variables that could predict noninducibility of sustained AF after PVI. METHODS AND RESULTS:Data were collected prospec...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.00225.x
更新日期:2005-12-01 00:00:00