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Background: Cryoballoon ablation for atrial fibrillation (AF) requires adequate contact between the pulmonary vein (PV) antrum and cryoballoon. The surge of intraballoon pressure during the initial phase of ablation may change the balloon's shape and compliance, resulting in balloon dislodgement and loss of PV occlusion. Without continuous monitoring, this phenomenon is often undetected but can be associated with incomplete PV isolation (PVI). Methods: Primary cryoablation of AF was performed in 15 patients. PV occlusion status pre‐ and post‐freezing were analyzed with intracardiac echocardiography (ICE) and dielectric imaging‐based occlusion tool (DIOT) to calculate the incidence of expansion dislodgement of cryoballoon. Results: A total of 105 cryoablation applications were performed on 57 veins, including three common ostiums of left pulmonary veins. In the evaluation of PV occlusion, both modalities reported consistent results in 86.7% of the assessments. Despite complete PV occlusion before ablation, peri‐balloon leak after initiation of freezing was detected by ICE in 5/22 (22.7%) applications and by DIOT in 8/25 (32%) applications. Conclusion: Incidence of expansion dislodgement of the cryoballoon was detected in one‐fourth to one‐third of cryoablation applications depending on the imaging modality used, which was clinically frequent and significant. [ABSTRACT FROM AUTHOR]

Validation of echocardiographic methods for assessing left ventricular dysfunction in rats with myocardial infarction. Am J Physiol Heart Circ Physiol 287: H2049-H2053, 2004; doi:10.1152/ajpheart.00393.2004.--The rat infarct model is widely used in heart failure research, but few echocardiographic indexes of left ventricular (LV) function are validated in this model. Accordingly, the objective of this study was to validate a 13-segment LV wall motion score index (WMSI) and the myocardial performance index (MPI) in infarcted rats. Twenty-nine male Wistar rats underwent left coronary artery ligation or sham operation and were evaluated with two-dimensional and Doppler flow echocardiography 8 wk later. After echocardiography, invasive indexes were obtained using a high-fidelity catheter. WMSI and MPI were correlated with the invasive and noninvasive measurements of LV function. WMSI and MPI significantly correlated directly with end-diastolic pressure (r = 0.72 and 0.42 for WMSI and MPI, respectively) and the time constant of isovolumic relaxation (r = 0.68 and 0.48) and inversely with peak rate of rise of LV pressure (+dP/dt; r = -0.68 and -0.50), peak rate of decline in LV pressure (r = -0.57 and -0.44), LV developed pressure (r = -0.58 and -0.42), area fractional shortening (r = -0.85 and -0.53), and cardiac index (r = -0.74 and -0.74). Stepwise linear regression analyses revealed that LV end-diastolic pressure, +dP/dt, area fractional shortening, and cardiac index were independent determinants of WMSI (r = 0.994) and that cardiac index and +dP/dt were independent determinants of MPI (r = 0.781). We conclude that the 13-segment WMSI and MPI are reproducible and correlate strongly with established echocardiographic and invasive indexes of systolic and diastolic function. These findings support the use of WMSI and MPI as indexes of global LV function in the rat infarction model of heart failure. wall motion score index; myocardial performance index; heart failure; ventricular function; echocardiography

Remote Magnetic Navigation (RMN) is a well-described technology with which a flexible catheter is guided through vascular and cardiac structures by a directional magnetic field. When utilized with EAM, the technology allows for atraumatic and precise creation of real-time anatomical representation as well as stable positioning of the ablation catheter tip at the time of energy delivery. The present report describes an alternative method utilizing RMN during 3D Electroanatomic mapping to safely provide real-time visualization of SOV anatomy, including the coronary ostia, in patients undergoing mapping and ablation for idiopathic VAs. [ABSTRACT FROM AUTHOR]