Clinical utility of the 'balloon lever technique' in the right inferior pulmonary vein cryoballoon ablation

Autor: Yasushi Wakabayashi, Masanori Kobayashi, Tomohide Ichikawa, Takashi Koyama, Hidetoshi Abe
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Arrhythmia, Vol 39, Iss 1, Pp 42-51 (2023)
Druh dokumentu: article
ISSN: 1883-2148
1880-4276
DOI: 10.1002/joa3.12801
Popis: Abstract Background The acute success rate of pulmonary vein isolation (PVI) with cryoballoon (CB) is reported to be lower in the right inferior pulmonary vein (RIPV). This study aimed to investigate the utility of the “balloon lever technique (BLT)” for RIPV CB ablation. Methods We retrospectively studied consecutive patients who underwent CB‐PVI for atrial fibrillation between February 21, 2020 and June 3, 2022. RIPV cryoablation was performed according to a specific protocol. The patients underwent RIPV cryoablation using the conventional method. If the method was found ineffective, BLT cryoablation was performed. The acute success rate of RIPV CB ablation was examined. We also investigated the RIPV isolation rate and procedural parameters during conventional and BLT cryoablation. Results Ninety‐three patients were included in the analysis. RIPV isolation was achieved in 89.2% (83/93) of the patients using conventional method and subsequent BLT cryoablation. Meanwhile, 68 patients underwent BLT cryoablation because the conventional method was ineffective. RIPV was isolated with BLT in 85.3% (58/68) of patients. Additionally, BLT was found to be superior to conventional cryoablation in terms of nadir balloon temperature, freezing time, and thawing time to a specific temperature in patients who underwent both conventional and BLT cryoablations. Conclusions BLT is useful in RIPV cryoablation when the conventional method is ineffective. BLT cryoablation may be helpful, mainly because of the BLT‐mediated contact of the balloon with the bottom of the RIPV, which leads to optimal RIPV occlusion.
Databáze: Directory of Open Access Journals
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