Cryoballoon ablation for atrial fibrillation without the use of a contrast medium: a combination of the intracardiac echocardiography and pressure wave monitoring guided approach
| Autor: | Toyoaki Murohara, Takatsugu Hiramatsu, Hitoshi Ichimiya, Satoshi Yanagisawa, Satoshi Ichimiya, Daiki Yamashita, Yasuya Inden, Junji Watanabe, Yuichiro Makino, Jun Yonekawa, Yasuhiro Uchida, Masanari Kurobe, Akinori Satake, Masaaki Kanashiro, Yoshiaki Mizutani |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
media_common.quotation_subject medicine.medical_treatment Cryosurgery Recurrence Internal medicine Atrial Fibrillation Occlusion Humans Contrast (vision) Medicine Fluoroscopy Retrospective Studies media_common medicine.diagnostic_test business.industry Atrial fibrillation Vascular surgery Ablation medicine.disease Cardiac surgery Contrast medium Treatment Outcome Echocardiography Pulmonary Veins Catheter Ablation cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Heart and Vessels. 37:765-774 |
| ISSN: | 1615-2573 0910-8327 |
| Popis: | In cryoballoon ablation (CBA), a contrast medium is commonly used to confirm balloon occlusion of the pulmonary veins (PVs). However, a contrast medium cannot always be used in patients with renal dysfunction and allergy. The present study aimed to assess the efficacy and safety of CBA without the use of a contrast medium. We retrospectively examined consecutive patients with paroxysmal atrial fibrillation (PAF) who underwent first-time CBA. We compared the procedural results and outcomes in patients for whom a contrast medium was used (contrast group) and those from whom a contrast medium was not used (non-contrast group). In the non-contrast group, we used saline injection on the intracardiac echocardiography and pressure wave monitoring for PV occlusion. Fifty patients (200 PVs) and 22 patients (88 PVs) underwent CBA with and without a contrast medium, respectively. The success rate of PV isolation with CBA alone was 93% and 90% in the non-contrast and contrast groups, respectively (p = 0.40). The fluoroscopy time and nadir temperature were significantly lower in the non-contrast group as compared to that in the contrast group. The recurrence rate 1 year after ablation did not differ between the two groups (18% vs. 18%, p > 0.99). Furthermore, the number of reconnected PVs in patients with recurrence was significantly lower in the non-contrast group than in the contrast group (6% vs. 36%, p = 0.017). In conclusion, CBA using the intracardiac echocardiography and pressure monitoring approach without the use of a contrast medium was safe and efficient. |
| Databáze: | OpenAIRE |
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