Comparison of Cryoballoon Ablation for Atrial Fibrillation Guided by Real-time Three-dimensional Transesophageal Echocardiography Vs. Contrast Agent Injection

Overview

Journal Chin Med J (Engl)

Specialty General Medicine

Date 2019 Jan 26

PMID 30681494

Citations 3

Authors

Yuan-Jun Sun

Xiao-Meng Yin

Tao Cong

Lian-Jun Gao

Dong Chang

Xian-Jie Xiao

Qiao-Bing Sun

Rong-Feng Zhang

Xiao-Hong Yu

Ying-Xue Dong

Yan-Zong Yang

Yun-Long Xia

Affiliations

Soon will be listed here.

Abstract

Background: Pulmonary vein (PV) occlusion generally depends on repetitive contrast agent injection when cryoballoon ablation for atrial fibrillation (AF). The present study was to compare the effect of cryoballoon ablation for AF guided by transesophageal echocardiography (TEE) vs. contrast agent injection.

Methods: Eighty patients with paroxysmal AF (PAF) were enrolled in the study. About 40 patients underwent cryoballoon ablation without TEE (non-TEE group) and the other 40 underwent cryoballoon ablation with TEE for PV occlusion (TEE group). In the TEE group during the procedure, PVs were displayed in 3-dimensional images to guide the balloon to achieve PV occlusion. The patients were followed up at regularly scheduled visits every 2 months.

Results: No differences were identified between the groups in regard to the procedure time and cryoablation time for each PV. The fluoroscopy time (6.7 ± 4.2 min vs. 17.9 ± 5.9 min, P < 0.05) and the amount of contrast agent (3.0 ± 5.1 mL vs.18.1 ± 3.4 mL, P < 0.05) in the TEE group were both less than the non-TEE group. At a mean of 13.0 ± 3.3 mon follow-up, success rates were similar between the TEE group and non-TEE group (77.5% vs. 80.0%, P = 0.88).

Conclusions: Cryoballoon ablation with TEE for occlusion of the PV is both safe and effective. Less fluoroscopy time and a lower contrast agent load can be achieved with the help of TEE for PV occlusion during procedure.

Citing Articles

Three-dimensional transesophageal echocardiographic evaluation of pulmonary vein anatomy prior to cryoablation: validation with cardiac CT scan.

Nagy L, Jenei C, Papp T, Urbancsek R, Kolozsvari R, Racz A Cardiovasc Ultrasound. 2023; 21(1):6.

PMID: 37076858 PMC: 10114354. DOI: 10.1186/s12947-023-00305-9.

Acute Safety and Efficacy of Fluoroless Cryoballoon Ablation for Atrial Fibrillation.

Alyesh D, Venkataraman G, Stucky A, Joyner J, Choe W, Sundaram S J Innov Card Rhythm Manag. 2021; 12(2):4413-4420.

PMID: 33654573 PMC: 7906563. DOI: 10.19102/icrm.2021.120205.

Significance of serum fibroblast growth factor-23 and miR-208b in pathogenesis of atrial fibrillation and their relationship with prognosis.

Chen J, Zhong Y, Tu C, Lan J World J Clin Cases. 2020; 8(16):3458-3464.

PMID: 32913852 PMC: 7457118. DOI: 10.12998/wjcc.v8.i16.3458.

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