The Influence of Pulmonary Veins' Anatomic Features and Catheter Coaxiality on Cryoballoon Ablation Results for Paroxysmal Atrial Fibrillation
A total of 172 consecutive patients with sympathetic paroxysmal atrial fibrillation who received cryoballoon (CB) ablation from 2020 to 2021 were retrospectively analyzed in this study. Catheter coaxiality and anatomic features of pulmonary veins (PVs) on computed tomography images were explored by...
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| Veröffentlicht in: | The American journal of cardiology 2023-12, Vol.209, p.12-19 |
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| creator | Pang, Yang Guo, Weifeng Xu, Ye Chen, Chaofeng Chen, Qingxing Cheng, Kuan Ling, Yunlong Liu, Guijian Ge, Junbo Wang, Mingliang Zhu, Wenqing |
| description | A total of 172 consecutive patients with sympathetic paroxysmal atrial fibrillation who received cryoballoon (CB) ablation from 2020 to 2021 were retrospectively analyzed in this study. Catheter coaxiality and anatomic features of pulmonary veins (PVs) on computed tomography images were explored by several parameters and their influence on the cryoablation results was then analyzed. The rate of incomplete CB occlusion was significantly higher for inferior than superior PVs. A multivariate analysis revealed that a short distance ( |
| doi_str_mv | 10.1016/j.amjcard.2023.09.067 |
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Catheter coaxiality and anatomic features of pulmonary veins (PVs) on computed tomography images were explored by several parameters and their influence on the cryoablation results was then analyzed. The rate of incomplete CB occlusion was significantly higher for inferior than superior PVs. A multivariate analysis revealed that a short distance (<6.3 mm) from PV ostium to first branch (D-PVB) and a small angle (<32.5°) of first branch were independent predict factors for an incomplete CB occlusion in right inferior PVs (RIPVs). A combination of D-PVB and angle of first branch could elevate the predictor value for an incomplete balloon occlusion with a sensitivity of 0.85 and specificity of 1.0 for RIPVs. For PVs with a perfect balloon occlusion, the best catheter coaxiality was observed in right superior PV while the worst catheter coaxiality was observed in RIPV. A more aggressive catheter manipulation with a "7" or "reverse-U" shape of long sheath could obtain a better catheter coaxiality compared with conventional manipulation strategy for RIPVs. In Conclusion, a short D-PVB and a small angle of first branch were independent predict factors for an incomplete CB occlusion in RIPVs. A more aggressive catheter manipulation strategy was recommended to achieve a complete balloon occlusion and a better catheter coaxiality for RIPVs.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2023.09.067</identifier><identifier>PMID: 37856915</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Ablation ; Atrial Fibrillation - surgery ; Cardiac arrhythmia ; Catheter Ablation ; Catheters ; Computed tomography ; Cryosurgery - methods ; Fibrillation ; Humans ; Medical instruments ; Multivariate analysis ; Occlusion ; Pulmonary Veins - diagnostic imaging ; Pulmonary Veins - surgery ; Retrospective Studies ; Sheaths ; Treatment Outcome ; Veins ; Veins & arteries</subject><ispartof>The American journal of cardiology, 2023-12, Vol.209, p.12-19</ispartof><rights>Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.</rights><rights>2023. The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c332t-d4ebeadb3c4bf259cb95a7f852a7f2658b8f00ab1fbda5021b76e0d510815c173</cites><orcidid>0000-0001-8229-0934</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2889067398?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37856915$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pang, Yang</creatorcontrib><creatorcontrib>Guo, Weifeng</creatorcontrib><creatorcontrib>Xu, Ye</creatorcontrib><creatorcontrib>Chen, Chaofeng</creatorcontrib><creatorcontrib>Chen, Qingxing</creatorcontrib><creatorcontrib>Cheng, Kuan</creatorcontrib><creatorcontrib>Ling, Yunlong</creatorcontrib><creatorcontrib>Liu, Guijian</creatorcontrib><creatorcontrib>Ge, Junbo</creatorcontrib><creatorcontrib>Wang, Mingliang</creatorcontrib><creatorcontrib>Zhu, Wenqing</creatorcontrib><title>The Influence of Pulmonary Veins' Anatomic Features and Catheter Coaxiality on Cryoballoon Ablation Results for Paroxysmal Atrial Fibrillation</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>A total of 172 consecutive patients with sympathetic paroxysmal atrial fibrillation who received cryoballoon (CB) ablation from 2020 to 2021 were retrospectively analyzed in this study. Catheter coaxiality and anatomic features of pulmonary veins (PVs) on computed tomography images were explored by several parameters and their influence on the cryoablation results was then analyzed. The rate of incomplete CB occlusion was significantly higher for inferior than superior PVs. A multivariate analysis revealed that a short distance (<6.3 mm) from PV ostium to first branch (D-PVB) and a small angle (<32.5°) of first branch were independent predict factors for an incomplete CB occlusion in right inferior PVs (RIPVs). A combination of D-PVB and angle of first branch could elevate the predictor value for an incomplete balloon occlusion with a sensitivity of 0.85 and specificity of 1.0 for RIPVs. For PVs with a perfect balloon occlusion, the best catheter coaxiality was observed in right superior PV while the worst catheter coaxiality was observed in RIPV. A more aggressive catheter manipulation with a "7" or "reverse-U" shape of long sheath could obtain a better catheter coaxiality compared with conventional manipulation strategy for RIPVs. In Conclusion, a short D-PVB and a small angle of first branch were independent predict factors for an incomplete CB occlusion in RIPVs. A more aggressive catheter manipulation strategy was recommended to achieve a complete balloon occlusion and a better catheter coaxiality for RIPVs.</description><subject>Ablation</subject><subject>Atrial Fibrillation - surgery</subject><subject>Cardiac arrhythmia</subject><subject>Catheter Ablation</subject><subject>Catheters</subject><subject>Computed tomography</subject><subject>Cryosurgery - methods</subject><subject>Fibrillation</subject><subject>Humans</subject><subject>Medical instruments</subject><subject>Multivariate analysis</subject><subject>Occlusion</subject><subject>Pulmonary Veins - diagnostic imaging</subject><subject>Pulmonary Veins - surgery</subject><subject>Retrospective Studies</subject><subject>Sheaths</subject><subject>Treatment Outcome</subject><subject>Veins</subject><subject>Veins & arteries</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdkc2KFDEUhYMoTk_rIygBF86myvx0qirLprB1YMBBRrchSSVMilQyJimYfgmf2TTdunBzf-A7l8M9ALzDqMUId5_mVi6zlmlqCSK0RbxFXf8CbPDQ8wZzTF-CDUKINBzv-BW4znmuK8asew2uaD-wjmO2Ab8fHg28DdavJmgDo4X3q19ikOkIfxoX8ke4D7LExWl4MLKsyWQowwRHWR5NMQmOUT476V05whjgmI5RSe9jnffKy-Lq8N3k1ZcMbUzwXqb4fMyL9HBfUhXCg1PJ-TP6Bryy0mfz9tK34Mfh88P4tbn79uV23N81mlJSmmlnlJGTonqnLGFcK85kbwdGaiUdG9RgEZIKWzVJhghWfWfQxDAaMNO4p1twc777lOKv1eQiFpe1qS6CiWsWZBgQRmhHeUU__IfOcU2hujtRvH6d8qFS7EzpFHNOxoqn5Jb6RYGROAUmZnEJTJwCE4iLk3QL3l-ur2ox0z_V34ToH3bblis</recordid><startdate>20231215</startdate><enddate>20231215</enddate><creator>Pang, Yang</creator><creator>Guo, Weifeng</creator><creator>Xu, Ye</creator><creator>Chen, Chaofeng</creator><creator>Chen, Qingxing</creator><creator>Cheng, Kuan</creator><creator>Ling, Yunlong</creator><creator>Liu, Guijian</creator><creator>Ge, Junbo</creator><creator>Wang, Mingliang</creator><creator>Zhu, Wenqing</creator><general>Elsevier Limited</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>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8229-0934</orcidid></search><sort><creationdate>20231215</creationdate><title>The Influence of Pulmonary Veins' Anatomic Features and Catheter Coaxiality on Cryoballoon Ablation Results for Paroxysmal Atrial Fibrillation</title><author>Pang, Yang ; 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Catheter coaxiality and anatomic features of pulmonary veins (PVs) on computed tomography images were explored by several parameters and their influence on the cryoablation results was then analyzed. The rate of incomplete CB occlusion was significantly higher for inferior than superior PVs. A multivariate analysis revealed that a short distance (<6.3 mm) from PV ostium to first branch (D-PVB) and a small angle (<32.5°) of first branch were independent predict factors for an incomplete CB occlusion in right inferior PVs (RIPVs). A combination of D-PVB and angle of first branch could elevate the predictor value for an incomplete balloon occlusion with a sensitivity of 0.85 and specificity of 1.0 for RIPVs. For PVs with a perfect balloon occlusion, the best catheter coaxiality was observed in right superior PV while the worst catheter coaxiality was observed in RIPV. A more aggressive catheter manipulation with a "7" or "reverse-U" shape of long sheath could obtain a better catheter coaxiality compared with conventional manipulation strategy for RIPVs. In Conclusion, a short D-PVB and a small angle of first branch were independent predict factors for an incomplete CB occlusion in RIPVs. A more aggressive catheter manipulation strategy was recommended to achieve a complete balloon occlusion and a better catheter coaxiality for RIPVs.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>37856915</pmid><doi>10.1016/j.amjcard.2023.09.067</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8229-0934</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Ablation Atrial Fibrillation - surgery Cardiac arrhythmia Catheter Ablation Catheters Computed tomography Cryosurgery - methods Fibrillation Humans Medical instruments Multivariate analysis Occlusion Pulmonary Veins - diagnostic imaging Pulmonary Veins - surgery Retrospective Studies Sheaths Treatment Outcome Veins Veins & arteries |
| title | The Influence of Pulmonary Veins' Anatomic Features and Catheter Coaxiality on Cryoballoon Ablation Results for Paroxysmal Atrial Fibrillation |
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