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Article: Impact of duration of cryothermal application on clinical efficacy of pulmonary vein isolation using transvenous cryoablation

TitleImpact of duration of cryothermal application on clinical efficacy of pulmonary vein isolation using transvenous cryoablation
Authors
Issue Date2005
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
Citation
Pace - Pacing And Clinical Electrophysiology, 2005, v. 28 n. 8, p. 839-843 How to Cite?
AbstractBackground: Recent studies have demonstrated that transvenous cryoablation is a safe and feasible method for pulmonary vein (PV) isolation for treatment of atrial fibrillation (AF). However, this technique is limited by a much longer ablation time than conventional radiofrequency ablation. The aim of this study was to determine the effect of duration of cryoablation application with double freeze-thaw cycles on clinical efficacy for PV isolation for treatment of AF. Materials and Results: We compared the clinical efficacy and procedural time of cryoablation (CryoCorTM, San Diego, CA, USA) for segmental PVisolation in 30 patients (mean age 51 ± 13, 20 men) with paroxysmal AF using either double 5-minute (n = 15) or double 2.5-minute (n = 15) freeze-thaw cycle delivered with a 10 F deflectable transvenous catheter. Clinical recurrence of AF and the occurrence of PV stenosis as determined by computer tomography of the thorax were performed at 3- and 12-month follow-up. Acute successful electrical isolation of PV was achieved with cryoablation in 96 of 98 (98%) targeted PVs in 30 patients (mean: 3.2 ± 0.8 PVs per patient). There were no significant differences between the baseline characteristics, the number of PV isolated per patient, the total number and percentage of effective cryoablation and the acute clinical efficacy between using double 5-minute and double 2.5-minute freezes (P > 0.05). However, the fluoroscopy time (107 ± 43 vs 138 ± 113 minutes, P = 0.06) and the procedural time (360 ± 113 vs 510 ± 115 minutes, P = 0.01) of using double 2.5-minute freezes was reduced by ~30% compared with double 5-minute freezes. At a mean of 20 ± 8 month follow-up, there was no significant difference in the chronic clinical efficacy of cryoablation in terms of freedom from AF in the absence of antiarrhythmic drug therapy between using double 5-minute (6/15, 40%) and double 2.5-minute freezes (7/15, 46%, P = 0.98). Conclusion: As compared with double 5-minute freeze, the use of a shorter double 2.5-minute freeze protocol significantly reduces the procedural time without affecting the acute and long-term clinical efficacy of cryoablation to isolate PV for treatment of AF.
Persistent Identifierhttp://hdl.handle.net/10722/162903
ISSN
2015 Impact Factor: 1.156
2015 SCImago Journal Rankings: 0.662
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_US
dc.contributor.authorLau, CPen_US
dc.date.accessioned2012-09-05T05:25:06Z-
dc.date.available2012-09-05T05:25:06Z-
dc.date.issued2005en_US
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2005, v. 28 n. 8, p. 839-843en_US
dc.identifier.issn0147-8389en_US
dc.identifier.urihttp://hdl.handle.net/10722/162903-
dc.description.abstractBackground: Recent studies have demonstrated that transvenous cryoablation is a safe and feasible method for pulmonary vein (PV) isolation for treatment of atrial fibrillation (AF). However, this technique is limited by a much longer ablation time than conventional radiofrequency ablation. The aim of this study was to determine the effect of duration of cryoablation application with double freeze-thaw cycles on clinical efficacy for PV isolation for treatment of AF. Materials and Results: We compared the clinical efficacy and procedural time of cryoablation (CryoCorTM, San Diego, CA, USA) for segmental PVisolation in 30 patients (mean age 51 ± 13, 20 men) with paroxysmal AF using either double 5-minute (n = 15) or double 2.5-minute (n = 15) freeze-thaw cycle delivered with a 10 F deflectable transvenous catheter. Clinical recurrence of AF and the occurrence of PV stenosis as determined by computer tomography of the thorax were performed at 3- and 12-month follow-up. Acute successful electrical isolation of PV was achieved with cryoablation in 96 of 98 (98%) targeted PVs in 30 patients (mean: 3.2 ± 0.8 PVs per patient). There were no significant differences between the baseline characteristics, the number of PV isolated per patient, the total number and percentage of effective cryoablation and the acute clinical efficacy between using double 5-minute and double 2.5-minute freezes (P > 0.05). However, the fluoroscopy time (107 ± 43 vs 138 ± 113 minutes, P = 0.06) and the procedural time (360 ± 113 vs 510 ± 115 minutes, P = 0.01) of using double 2.5-minute freezes was reduced by ~30% compared with double 5-minute freezes. At a mean of 20 ± 8 month follow-up, there was no significant difference in the chronic clinical efficacy of cryoablation in terms of freedom from AF in the absence of antiarrhythmic drug therapy between using double 5-minute (6/15, 40%) and double 2.5-minute freezes (7/15, 46%, P = 0.98). Conclusion: As compared with double 5-minute freeze, the use of a shorter double 2.5-minute freeze protocol significantly reduces the procedural time without affecting the acute and long-term clinical efficacy of cryoablation to isolate PV for treatment of AF.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1en_US
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiologyen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAnalysis Of Varianceen_US
dc.subject.meshAtrial Fibrillation - Surgeryen_US
dc.subject.meshChi-Square Distributionen_US
dc.subject.meshCryosurgery - Methodsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPostoperative Complicationsen_US
dc.subject.meshPulmonary Veins - Surgeryen_US
dc.subject.meshTime Factorsen_US
dc.subject.meshTomography, Spiral Computeden_US
dc.subject.meshTreatment Outcomeen_US
dc.titleImpact of duration of cryothermal application on clinical efficacy of pulmonary vein isolation using transvenous cryoablationen_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1540-8159.2005.00174.xen_US
dc.identifier.pmid16105012-
dc.identifier.scopuseid_2-s2.0-27844494314en_US
dc.identifier.hkuros100826-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-27844494314&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume28en_US
dc.identifier.issue8en_US
dc.identifier.spage839en_US
dc.identifier.epage843en_US
dc.identifier.isiWOS:000231683800015-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US
dc.identifier.citeulike274824-

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