Publications by authors named "Britta Schulte-Hahn"
Article Synopsis
- Management of atrial fibrillation (AF) in severely obese patients is complex, but cryoballoon ablation (CBA) shows encouraging results despite certain risks.
- In a study involving 72 severely obese patients (BMI ≥ 40 kg/m) compared to 129 normal-weight patients (BMI < 25 kg/m), similar procedural times were observed, but severely obese patients had higher radiation exposure and more complications.
- Although outcomes for paroxysmal and persistent AF were slightly lower in severely obese patients, CBA is still a viable treatment option with relatively good success rates.
Background: The cryoballoon (CB) represents the gold standard single-shot device for pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Single-shot pulsed field PVI ablation (nonthermal, cardiac tissue selective) has recently entered the arena. We sought to compare procedural data and long-term outcome of both techniques.
View Article and Find Full Text PDFFirst pulse field ablation of an incessant atrial tachycardia from the right atrial appendage.
J Interv Card Electrophysiol
December 2022
We report a case of an incessant atrial tachycardia from the right atrial appendage that was effectively treated with pulsed field ablation after two failed radio frequency ablation attempts.
View Article and Find Full Text PDFAn 89-year-old woman underwent left atrial appendage (LAA) closure (LAAC) in our hospital because of recurrent gastrointestinal bleedings. The first transesophageal echocardiography (TEE) follow-up at six weeks revealed a complete sealing of the LAA and no device related thrombus. In a TEE follow-up at one year after the LAA closure, a large device related thrombus (6 × 3 cm) was found.
View Article and Find Full Text PDFIntroduction: Ablation of atrial fibrillation in the context of obesity can be challenging. We sought to evaluate the role of cryoballoon pulmonary vein isolation (CB-PVI) in obese patients with symptomatic atrial fibrillation (AF).
Methods: Patients with a BMI ≥ 25 kg/m and symptomatic AF who underwent CB-PVI were retrospectively enrolled.
Article Synopsis
- A new radiofrequency ablation strategy using high power (50W) and an ablation index (AI) aims to improve treatment outcomes for patients with atrial fibrillation (AF).
- The study included 122 symptomatic AF patients undergoing pulmonary vein isolation, achieving a 96.7% success rate on the first try and minimal procedural complications, with only 2.5% experiencing minor esophageal issues.
- After 15 months, 85.2% of patients remained free from AF episodes without antiarrhythmic medications, indicating the effectiveness of the AI-HP technique.
Aims: Pulmonary vein isolation (PVI) using the first-generation cryoballoon (CB1) was characterized by a high rate of recovered pulmonary vein (PV) conduction along with a typical conduction gap pattern in patients with recurrent atrial tachyarrhythmia (ATa). Second generation (CB2) enables more uniform freezing. However, the rate of chronic PVI and PV conduction gap pattern is unknown.
View Article and Find Full Text PDFAims: The second-generation cryoballoon (CB2) with increased surface cooling has recently become available. The aim was to investigate the incidence and characteristics of phrenic nerve palsy (PNP) during pulmonary vein isolation (PVI) using the CB2 as compared with the first-generation balloon (CB1).
Methods And Results: A total of 360 consecutive patients with atrial fibrillation underwent PVI with the CB1 (106 patients) or the CB2 (254 patients).
Background: The second-generation cryoballoon (CB2) has recently been introduced featuring improved surface cooling. Increased procedural efficacy of pulmonary vein isolation (PVI) when compared to the first-generation balloon (CB1) has been reported. The aim of the study was to investigate the clinical outcome of cryoballoon PVI after 1 year using the CB2 as compared to the CB1.
View Article and Find Full Text PDFAims: Recently, a novel second-generation (G2) cryoballoon (CB) was introduced. Comparative analysis of lesion formation in terms of myocardial biomarker release [first-generation CB (G1) vs. G2] has not been studied.
View Article and Find Full Text PDFArticle Synopsis
- Balloon catheters, specifically cryoballoons (CB) and laserballoons (LB), are being compared for their safety and effectiveness in treating patients with paroxysmal atrial fibrillation (PAF) in a study involving 140 participants.
- The study found that both types of balloon catheters were highly effective in isolating pulmonary veins, with a success rate of approximately 99% for the CB and nearly 99% for the LB.
- After a 12-month follow-up, the rates of atrial fibrillation recurrence were 37% for the CB group and 27% for the LB group, showing no statistically significant difference between the two methods in terms of rhythm stability.
Article Synopsis
- Pulmonary vein isolation is a common treatment for patients with atrial fibrillation who don't respond to medication.
- While radiofrequency ablation is the standard method, new technologies, like the endoscopic ablation system, allow better visualization of the veins during the procedure.
- Initial studies suggest that this new laser-based technique is both safe and effective, and further research could establish it as a leading option for treating cardiac arrhythmias.
Background: The novel second-generation cryoballoon (CB) facilitates pulmonary vein isolation (PVI) by improved surface cooling. The impact of this redesign on collateral damage is unknown.
Objective: To investigate the incidence of esophageal lesions after PVI using the second-generation CB and the role of luminal esophageal temperature (LET) measurement as a predictor of lesion formation.
Article Synopsis
- The study evaluated the effectiveness of a second-generation cryoballoon (CB-2G) compared to a first-generation cryoballoon (CB-1G) for isolating pulmonary veins in patients.
- The CB-2G showed a significant increase in single-shot pulmonary vein isolation rates from 51% to 84%, while also reducing the average procedure time and fluoroscopy exposure.
- Although complications were observed in both groups, the study concludes that the CB-2G enhances procedural efficiency and measurement reliability, but further research is needed for its safety profile.
Article Synopsis
- The study investigates the impact of low-dose and high-dose laser ablation on patients with atrial fibrillation, comparing their effectiveness in achieving acute and chronic pulmonary vein isolation.
- Results show that high-dose ablation yielded a significantly higher acute pulmonary vein isolation rate (89%) compared to low-dose (69%), and a better long-term success rate (83% chronic success) after a single procedure.
- Additionally, high-dose ablation required less overall energy and fewer applications, resulting in shorter procedure times compared to low-dose.
Article Synopsis
- Investigated the feasibility and safety of a single transseptal puncture (TP) approach using a new circumferential mapping catheter (CMC) for pulmonary vein isolation (PVI) with a 28-mm cryoballoon.
- Achieved the primary endpoint of successful PVI in 91% of patients, with an average procedure time of 126 minutes.
- Concluded that while the single TP method is safe and effective, improvements in real-time PV recording capabilities are needed, as it was only successful in less than 50% of the cases.
Article Synopsis
- Pulmonary vein isolation (PVI) can be effectively performed using a single endoscopic ablation system (EAS) and visual guidance, reducing the need for complex techniques and multiple punctures.
- In a study with 35 patients suffering from drug-refractory atrial fibrillation, the procedure achieved a 70% isolation rate at first and improved to 98% with additional ablation, showcasing promising results.
- Over a median follow-up of 266 days, 77% of patients remained free of tachyarrhythmia without relying on antiarrhythmic drugs, indicating good long-term effectiveness of the procedure.
During the past decade atrial fibrillation (AF) ablation has developed from being an experimental treatment option to an evidence based therapy implemented in current guidelines.[1-2] Irrigated radiofrequency current guided ablations remain the golden standard of pulmonary vein isolation (PVI) procedures. Although practiced more frequently, it remains a demanding procedure requiring skilful operators.
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