Safety and Feasibility of Electrical Isolation of the Superior Vena Cava in Addition to Pulmonary Vein Ablation for Paroxysmal Atrial Fibrillation Using the Cryoballoon: Lessons from a Prospective Study

Overview

Journal J Interv Card Electrophysiol

Publisher Springer

Date 2020 Apr 8

PMID 32253600

Citations 5

Authors

Saverio Iacopino

Thiago Guimaraes Osorio

Pasquale Filannino

Paolo Artale

Juan Sieira

Erwin Stroker

Gezim Bala

Ingrid Overeinder

Ebru Hacioglu

Paul-Adrian Calburean

Gaetano Paparella

Pedro Brugada

Carlo de Asmundis

Gian-Battista Chierchia

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to evaluate the feasibility and safety of superior vena cava (SVC) isolation in addition to standard pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB) in patients with paroxysmal atrial fibrillation.

Methods: Thirty-seven consecutive patients that underwent CB ablation for paroxysmal atrial fibrillation (PAF) were prospectively enrolled in our study. After PVI the SVC was mapped for potentials. If the SVC exhibited electrical activity, isolation was achieved performing a single 180-s balloon application.

Results: Regarding SVC isolation, 180-s freeze in the SVC could be completed in 32 (86.4%) patients, and 5 patients had at least 120 s of freezing application (13.5%). Real-time recording during SVC isolation was observed in 30 (81.0%) patients. The mean time to isolation was 36.9 ± 28.7 s and the temperature at isolation was - 33 (- 15 to - 40) °C. No cases developed persistent phrenic nerve palsy (PNP) or any other complication.

Conclusions: Superior vena cava isolation proved to be safe and feasible with the second generation cryoballoon in a prospective series of patients affected by PAF.

Citing Articles

Superior vena cava isolation using a pentaspline pulsed-field ablation catheter: feasibility and safety in patients undergoing atrial fibrillation catheter ablation.

Ollitrault P, Chaumont C, Font J, Manninger M, Conti S, Matusik P Europace. 2024; 26(7).

PMID: 38875490 PMC: 11252500. DOI: 10.1093/europace/euae160.

Long-term Outcomes of Cryoballoon-based Empirical Superior Vena Cava Isolation in Addition to Pulmonary Vein Isolation in Persistent Atrial Fibrillation.

Canpolat U, Yorgun H, Aytemir K Anatol J Cardiol. 2024; .

PMID: 38832523 PMC: 11426402. DOI: 10.14744/AnatolJCardiol.2024.4092.

Pulsed field ablation of superior vena cava in paroxysmal atrial fibrillation: a case report.

Tao Y, Zhou Y, Sun X, Liao W, Wang Y, Shi L Front Cardiovasc Med. 2023; 10:1211674.

PMID: 37456819 PMC: 10347413. DOI: 10.3389/fcvm.2023.1211674.

Empirical superior vena cava isolation improves outcomes of radiofrequency re-ablation in pulmonary vein isolation non-responders: A 2-center retrospective study in China.

Gu Z, Yang G, Ju W, Li M, Chen H, Gu K Front Cardiovasc Med. 2022; 9:1049414.

PMID: 36568556 PMC: 9768188. DOI: 10.3389/fcvm.2022.1049414.

Initial experience of a novel method for electrical isolation of the superior vena cava using cryoballoon in patients with atrial fibrillation.

Lin C, Bao Y, Xie Y, Wei Y, Luo Q, Ling T Clin Cardiol. 2022; 46(2):126-133.

PMID: 36403256 PMC: 9933103. DOI: 10.1002/clc.23947.

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