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Durability of cryoballoon left atrial appendage isolation: Acute and invasive remapping electrophysiological findings
- Source :
- Pacing and Clinical Electrophysiology. 42:646-654
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- Background The left atrial appendage (LAA) has been identified as a potential source of atrial fibrillation (AF) and has been described as the "fifth" pulmonary vein (PV). We report our initial experience in LAA isolation (LAAI) using the cryoballoon (CB) and data on durability of CB-LAAI. Methods Patients treated with a CB-LAAI were retrospectively identified. Six weeks after electrical LAAI, patients were scheduled for staged percutaneous LAA closure. During the second procedure, a subset of patients underwent invasive remapping of the LAA. Results A total of 32 patients (21 males, 68 ± 10 years old) were treated with CB-LAAI. Acute LAAI was achieved in 29 of 32 (91%) patients: single-shot LAAI was observed in 18 of 32 (56%) patients. Acute procedural sustained LAAI was related with a significantly shorter time to LAAI (sustained LAAI: 84 ± 50 s vs nonsustained LAAI: 166 ± 76 s, P = 0.004). Mean procedure and fluoroscopy time were 61 ± 29 and 8 ± 6 min, respectively. One left-sided phrenic nerve palsy occurred. In 25 of 32 (78%) patients, a second procedure for percutaneous LAA closure device implantation was performed. In 22 patients, persistency of LAAI was tested: durable LAAI was documented in 16/22 patients (73%). Conclusion In the present report, CB LAA isolation followed by staged LAA closure appeared to be safe and feasible but more data are required. Time to LAAI played a role in predicting acute sustained LAAI rate. CB LAA ablation leads to 73% of durable LAA isolation.
- Subjects :
- Epicardial Mapping
Male
medicine.medical_specialty
Percutaneous
medicine.medical_treatment
030204 cardiovascular system & hematology
Cryosurgery
Pulmonary vein
03 medical and health sciences
0302 clinical medicine
Left atrial
Internal medicine
Atrial Fibrillation
Occlusion
medicine
Humans
Fluoroscopy
Atrial Appendage
030212 general & internal medicine
Aged
Retrospective Studies
medicine.diagnostic_test
business.industry
Atrial fibrillation
General Medicine
medicine.disease
Ablation
Electrophysiology
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15408159 and 01478389
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Pacing and Clinical Electrophysiology
- Accession number :
- edsair.doi.dedup.....9acad2af7738f7bb061073aca206a618