Cryoballoon ablation for atrial fibrillation without the use of a contrast medium: a combination of the intracardiac echocardiography and pressure wave monitoring guided approach
In cryoballoon ablation (CBA), a contrast medium is commonly used to confirm balloon occlusion of the pulmonary veins (PVs). However, a contrast medium cannot always be used in patients with renal dysfunction and allergy. The present study aimed to assess the efficacy and safety of CBA without the u...
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| Veröffentlicht in: | Heart and vessels 2022-05, Vol.37 (5), p.765-774 |
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| creator | Makino, Yuichiro Mizutani, Yoshiaki Yamashita, Daiki Yonekawa, Jun Satake, Akinori Kurobe, Masanari Hiramatsu, Takatsugu Ichimiya, Hitoshi Uchida, Yasuhiro Watanabe, Junji Kanashiro, Masaaki Ichimiya, Satoshi Yanagisawa, Satoshi Inden, Yasuya Murohara, Toyoaki |
| description | In cryoballoon ablation (CBA), a contrast medium is commonly used to confirm balloon occlusion of the pulmonary veins (PVs). However, a contrast medium cannot always be used in patients with renal dysfunction and allergy. The present study aimed to assess the efficacy and safety of CBA without the use of a contrast medium. We retrospectively examined consecutive patients with paroxysmal atrial fibrillation (PAF) who underwent first-time CBA. We compared the procedural results and outcomes in patients for whom a contrast medium was used (contrast group) and those from whom a contrast medium was not used (non-contrast group). In the non-contrast group, we used saline injection on the intracardiac echocardiography and pressure wave monitoring for PV occlusion. Fifty patients (200 PVs) and 22 patients (88 PVs) underwent CBA with and without a contrast medium, respectively. The success rate of PV isolation with CBA alone was 93% and 90% in the non-contrast and contrast groups, respectively (
p
= 0.40). The fluoroscopy time and nadir temperature were significantly lower in the non-contrast group as compared to that in the contrast group. The recurrence rate 1 year after ablation did not differ between the two groups (18% vs. 18%,
p
> 0.99). Furthermore, the number of reconnected PVs in patients with recurrence was significantly lower in the non-contrast group than in the contrast group (6% vs. 36%,
p
= 0.017). In conclusion, CBA using the intracardiac echocardiography and pressure monitoring approach without the use of a contrast medium was safe and efficient. |
| doi_str_mv | 10.1007/s00380-021-01963-3 |
| format | Article |
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p
= 0.40). The fluoroscopy time and nadir temperature were significantly lower in the non-contrast group as compared to that in the contrast group. The recurrence rate 1 year after ablation did not differ between the two groups (18% vs. 18%,
p
> 0.99). Furthermore, the number of reconnected PVs in patients with recurrence was significantly lower in the non-contrast group than in the contrast group (6% vs. 36%,
p
= 0.017). In conclusion, CBA using the intracardiac echocardiography and pressure monitoring approach without the use of a contrast medium was safe and efficient.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-021-01963-3</identifier><identifier>PMID: 34636968</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Ablation ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - surgery ; Biomedical Engineering and Bioengineering ; Cardiac arrhythmia ; Cardiac Surgery ; Cardiology ; Catheter Ablation - adverse effects ; Contrast media ; Cryosurgery - adverse effects ; Cryosurgery - methods ; Echocardiography ; Echocardiography - methods ; Elastic waves ; Fibrillation ; Fluoroscopy ; Humans ; Medicine ; Medicine & Public Health ; Microscopes ; Monitoring ; Occlusion ; Original Article ; Pressure ; Pulmonary Veins - diagnostic imaging ; Pulmonary Veins - surgery ; Recurrence ; Renal function ; Retrospective Studies ; Treatment Outcome ; Vascular Surgery</subject><ispartof>Heart and vessels, 2022-05, Vol.37 (5), p.765-774</ispartof><rights>Springer Japan KK, part of Springer Nature 2021</rights><rights>2021. Springer Japan KK, part of Springer Nature.</rights><rights>Springer Japan KK, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-4f809a9421ca10c690560722c46ad946b2dd76a6aaa980ea61a345717bd92c533</citedby><cites>FETCH-LOGICAL-c399t-4f809a9421ca10c690560722c46ad946b2dd76a6aaa980ea61a345717bd92c533</cites><orcidid>0000-0001-9647-163X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-021-01963-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-021-01963-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27928,27929,41492,42561,51323</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34636968$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Makino, Yuichiro</creatorcontrib><creatorcontrib>Mizutani, Yoshiaki</creatorcontrib><creatorcontrib>Yamashita, Daiki</creatorcontrib><creatorcontrib>Yonekawa, Jun</creatorcontrib><creatorcontrib>Satake, Akinori</creatorcontrib><creatorcontrib>Kurobe, Masanari</creatorcontrib><creatorcontrib>Hiramatsu, Takatsugu</creatorcontrib><creatorcontrib>Ichimiya, Hitoshi</creatorcontrib><creatorcontrib>Uchida, Yasuhiro</creatorcontrib><creatorcontrib>Watanabe, Junji</creatorcontrib><creatorcontrib>Kanashiro, Masaaki</creatorcontrib><creatorcontrib>Ichimiya, Satoshi</creatorcontrib><creatorcontrib>Yanagisawa, Satoshi</creatorcontrib><creatorcontrib>Inden, Yasuya</creatorcontrib><creatorcontrib>Murohara, Toyoaki</creatorcontrib><title>Cryoballoon ablation for atrial fibrillation without the use of a contrast medium: a combination of the intracardiac echocardiography and pressure wave monitoring guided approach</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>In cryoballoon ablation (CBA), a contrast medium is commonly used to confirm balloon occlusion of the pulmonary veins (PVs). However, a contrast medium cannot always be used in patients with renal dysfunction and allergy. The present study aimed to assess the efficacy and safety of CBA without the use of a contrast medium. We retrospectively examined consecutive patients with paroxysmal atrial fibrillation (PAF) who underwent first-time CBA. We compared the procedural results and outcomes in patients for whom a contrast medium was used (contrast group) and those from whom a contrast medium was not used (non-contrast group). In the non-contrast group, we used saline injection on the intracardiac echocardiography and pressure wave monitoring for PV occlusion. Fifty patients (200 PVs) and 22 patients (88 PVs) underwent CBA with and without a contrast medium, respectively. The success rate of PV isolation with CBA alone was 93% and 90% in the non-contrast and contrast groups, respectively (
p
= 0.40). The fluoroscopy time and nadir temperature were significantly lower in the non-contrast group as compared to that in the contrast group. The recurrence rate 1 year after ablation did not differ between the two groups (18% vs. 18%,
p
> 0.99). Furthermore, the number of reconnected PVs in patients with recurrence was significantly lower in the non-contrast group than in the contrast group (6% vs. 36%,
p
= 0.017). In conclusion, CBA using the intracardiac echocardiography and pressure monitoring approach without the use of a contrast medium was safe and efficient.</description><subject>Ablation</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - surgery</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Catheter Ablation - adverse effects</subject><subject>Contrast media</subject><subject>Cryosurgery - adverse effects</subject><subject>Cryosurgery - methods</subject><subject>Echocardiography</subject><subject>Echocardiography - methods</subject><subject>Elastic waves</subject><subject>Fibrillation</subject><subject>Fluoroscopy</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microscopes</subject><subject>Monitoring</subject><subject>Occlusion</subject><subject>Original Article</subject><subject>Pressure</subject><subject>Pulmonary Veins - diagnostic imaging</subject><subject>Pulmonary Veins - surgery</subject><subject>Recurrence</subject><subject>Renal function</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1TAQhS1ERW8LL8ACWWLDJq1_Eidmh66AVqrEBtbWxHFuXCVx8A_VfS2eEOfmAhILVjMafXNmdA5Crym5oYTUt4EQ3pCCMFoQKgUv-DO0o4JWBatq_hztiKSkaDirL9FVCI-E0EpS-QJd8lJwIUWzQz_3_uhaGEfnZgztCNHmpnceQ_QWRtzb1tvxPH-ycXAp4jgYnILBrseAtZujhxDxZDqbpven0dTaedvJzIrbFdLgOwsaGz24U-8OHpbhiGHu8OJNCMkb_AQ_DJ7cbKPzdj7gQ7Kd6TAsi3egh5fooocxmFfneo2-ffr4dX9XPHz5fL__8FBoLmUsyr4hEmTJqAZKtJCkEqRmTJcCOlmKlnVdLUAAgGyIAUGBl1VN67aTTFecX6N3m24--z2ZENVkgzbZi9m4FBSrGsrqpuJNRt_-gz665Of8nWKirEWTM1optlHauxC86dXi7QT-qChRa6JqS1RlWp0SVesXb87Sqc0G_1n5HWEG-AaEZXXL-L-3_yP7C8KLr2U</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Makino, Yuichiro</creator><creator>Mizutani, Yoshiaki</creator><creator>Yamashita, Daiki</creator><creator>Yonekawa, Jun</creator><creator>Satake, Akinori</creator><creator>Kurobe, Masanari</creator><creator>Hiramatsu, Takatsugu</creator><creator>Ichimiya, Hitoshi</creator><creator>Uchida, Yasuhiro</creator><creator>Watanabe, Junji</creator><creator>Kanashiro, Masaaki</creator><creator>Ichimiya, Satoshi</creator><creator>Yanagisawa, Satoshi</creator><creator>Inden, Yasuya</creator><creator>Murohara, Toyoaki</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9647-163X</orcidid></search><sort><creationdate>20220501</creationdate><title>Cryoballoon ablation for atrial fibrillation without the use of a contrast medium: a combination of the intracardiac echocardiography and pressure wave monitoring guided approach</title><author>Makino, Yuichiro ; 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However, a contrast medium cannot always be used in patients with renal dysfunction and allergy. The present study aimed to assess the efficacy and safety of CBA without the use of a contrast medium. We retrospectively examined consecutive patients with paroxysmal atrial fibrillation (PAF) who underwent first-time CBA. We compared the procedural results and outcomes in patients for whom a contrast medium was used (contrast group) and those from whom a contrast medium was not used (non-contrast group). In the non-contrast group, we used saline injection on the intracardiac echocardiography and pressure wave monitoring for PV occlusion. Fifty patients (200 PVs) and 22 patients (88 PVs) underwent CBA with and without a contrast medium, respectively. The success rate of PV isolation with CBA alone was 93% and 90% in the non-contrast and contrast groups, respectively (
p
= 0.40). The fluoroscopy time and nadir temperature were significantly lower in the non-contrast group as compared to that in the contrast group. The recurrence rate 1 year after ablation did not differ between the two groups (18% vs. 18%,
p
> 0.99). Furthermore, the number of reconnected PVs in patients with recurrence was significantly lower in the non-contrast group than in the contrast group (6% vs. 36%,
p
= 0.017). In conclusion, CBA using the intracardiac echocardiography and pressure monitoring approach without the use of a contrast medium was safe and efficient.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>34636968</pmid><doi>10.1007/s00380-021-01963-3</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9647-163X</orcidid></addata></record> |
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| ispartof | Heart and vessels, 2022-05, Vol.37 (5), p.765-774 |
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| subjects | Ablation Atrial Fibrillation - diagnosis Atrial Fibrillation - surgery Biomedical Engineering and Bioengineering Cardiac arrhythmia Cardiac Surgery Cardiology Catheter Ablation - adverse effects Contrast media Cryosurgery - adverse effects Cryosurgery - methods Echocardiography Echocardiography - methods Elastic waves Fibrillation Fluoroscopy Humans Medicine Medicine & Public Health Microscopes Monitoring Occlusion Original Article Pressure Pulmonary Veins - diagnostic imaging Pulmonary Veins - surgery Recurrence Renal function Retrospective Studies Treatment Outcome Vascular Surgery |
| title | Cryoballoon ablation for atrial fibrillation without the use of a contrast medium: a combination of the intracardiac echocardiography and pressure wave monitoring guided approach |
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