Pulmonary Vein Anatomy is Associated with Cryo Kinetics During Cryoballoon Ablation for Atrial Fibrillation

Overview

Journal Arq Bras Cardiol

Specialty Cardiology & Vascular Diseases

Date 2018 Jun 14

PMID 29898044

Citations 4

Authors

Xiongbiao Chen

Pihua Fang

Zheng Liu

Jia He

Min Tang

Jun Liu

Bin Lu

Shu Zhang

Affiliations

Soon will be listed here.

Abstract

Background: The influence of pulmonary vein (PV) anatomy on cryo kinetics during cryoballoon (CB) ablation is unclear.

Objective: To investigate the relationship between PV anatomy and cryo kinetics during CB ablation for atrial fibrillation (AF).

Methods: Sixty consecutive patients were enrolled. PV anatomy, including ostial diameters (long, short and corrected), ratio between short and long diameters, ostium shape (round, oval, triangular, and narrow), and drainage pattern (typical, with common trunk, common antrum, ostial branch and supernumerary PV) were evaluated on multi-detector computed tomography (MDCT) images pre-procedure. Cryo kinetics parameters [balloon freeze time from 0 to -30ºC (BFT), balloon nadir temperature (BNT) and balloon warming time from -30 to +15ºC (BWT)] were recorded during procedure. All p values are two-sided, with values of p < 0.05 considered to be statistically significant.

Results: 606 times of freezing cycle were accomplished. Moderate negative correlation was documented between BNT and corrected PV diameter (r = -0.51, p < 0.001) when using 23-mm CBs, and mild negative correlation (r = - 0.32, p = 0.001) was found when using 28-mm CBs. Multivariate logistic regression analysis revealed that PV corrected ostial diameter (OR, 1.4; p = 0.004) predicted a BNT < -51ºC when using 23-mm CBs, while PV ostium oval shape (OR, 0.3; p = 0.033) and PV locations (left inferior PV: OR, 0.04; p = 0.005; right superior PV: OR, 4.3; p = 0.025) predicted BNT < -51ºC when using 28-mm CBs.

Conclusions: MDCT can provide PV anatomy accurate evaluation prior CB ablation. PV anatomy is associated with cryo kinetics during ablation.

Citing Articles

Procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy.

Menger V, Frick M, Sharif-Yakan A, Emrani M, Zink M, Napp A J Arrhythm. 2023; 39(3):341-351.

PMID: 37324756 PMC: 10264750. DOI: 10.1002/joa3.12842.

Cryoballoon Ablation for Treatment of Atrial Fibrillation in a Chinese Population: Five-Year Outcomes and Predictors of Recurrence After a Single Procedure.

Chen X, Xia Y, Lin Y, Li X, Wang C, Chen Y Front Cardiovasc Med. 2022; 9:836392.

PMID: 35571157 PMC: 9091437. DOI: 10.3389/fcvm.2022.836392.

The influence of metabolic syndrome on atrial fibrillation recurrence: five-year outcomes after a single cryoballoon ablation procedure.

Xia Y, Li X, Liu J, Yu M, Fang P, Zhang S J Geriatr Cardiol. 2022; 18(12):1019-1028.

PMID: 35136397 PMC: 8782764. DOI: 10.11909/j.issn.1671-5411.2021.12.008.

Impact of pulmonary vein ovality index on cooling kinetics and acute success of atrial fibrillation ablation with the third-generation cryoballoon catheter.

Stachyra M, Szczasny M, Tarkowski A, Mianowana M, Wojewoda K, Wysokinska K Postepy Kardiol Interwencyjnej. 2022; 17(4):403-409.

PMID: 35126556 PMC: 8802643. DOI: 10.5114/aic.2021.110927.

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