Balloon catheter ablation to treat paroxysmal atrial fibrillation: what is the level of pulmonary venous isolation?
Language English Country United States Media print-electronic
Document type Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
Grant support
HL68064
NHLBI NIH HHS - United States
PubMed
18313591
DOI
10.1016/j.hrthm.2007.11.006
PII: S1547-5271(07)01101-0
Knihovny.cz E-resources
- MeSH
- Echocardiography MeSH
- Electrophysiologic Techniques, Cardiac MeSH
- Endoscopy MeSH
- Atrial Fibrillation surgery MeSH
- Catheterization MeSH
- Catheter Ablation methods MeSH
- Cryotherapy MeSH
- Laser Therapy methods MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Tomography, X-Ray Computed MeSH
- Pulmonary Veins * MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Research Support, N.I.H., Extramural MeSH
- Comparative Study MeSH
BACKGROUND: Unlike the initial balloon ablation catheters that were designed to deliver ablation lesions within the pulmonary veins (PVs), the current balloon prototypes are fashioned to deliver lesions at the PV ostia. OBJECTIVE: Using electroanatomical mapping, this study evaluates the actual location of ablation lesions generated by cryo-based, laser-based, or ultrasound-based balloon catheters. METHODS: In a total of 14 patients with paroxysmal atrial fibrillation, PV isolation was performed using either a cryoballoon catheter (8 patients), laser catheter (4 patients) or ultrasound balloon catheter (2 patients). Patients underwent preprocedural computed tomographic/magnetic resonance imaging. An intracardiac ultrasound catheter was used to aid in positioning the balloon catheter at the PV ostium/antrum. In all patients, sinus rhythm bipolar voltage amplitude maps (using either CARTO with computed tomographic/magnetic resonance image integration or NavX mapping) were generated at baseline and after electrical PV isolation as confirmed by use of a circular mapping catheter. RESULTS: Electrical isolation was achieved in 100% of the PVs. Electroanatomical mapping revealed that after ablation with any of the 3 balloon catheters, the extent of isolation included the tubular portions of each PV to the level of the PV ostia. However, the PV antral portions were left largely unablated with all 3 balloon technologies. CONCLUSION: Using the current generation of balloon ablation catheters, electrical isolation occurs at the level of the PV ostia, but the antral regions are largely unablated.
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