Transesophageal echocardiography guided transseptal puncture and nadir temperatures in cryoballoon pulmonary vein isolation.

Introduction: Cryoballoon (CB) guided pulmonary vein isolation (PVI) is an established procedure in the treatment of atrial fibrillation (AF). Transseptal access is an indispensable step during PVI and may be associated with severe complications. For specific interventions, specific puncture sites of the fossa ovalis are advantageous.

Wearable Cardioverter-Defibrillator Used as a Telemonitoring System in a Real-Life Heart Failure Unit Setting.

Background: In patients with reduced left ventricular ejection fraction (LVEF) who are at risk of sudden cardiac death, a wearable cardioverter-defibrillator (WCD) is recommended as a bridge to the recovery of LVEF or as a bridge to the implantation of a device. In addition to its function to detect and treat malignant arrhythmia, WCD can be used via an online platform as a telemonitoring system to supervise patients' physical activity, compliance, and heart rate.

Methods: We retrospectively analyzed 173 patients with regard to compliance and heart rate after discharge.

Reduction of Radiation Exposure in Atrioventricular Nodal Reentrant Tachycardia Ablations Using an Electroanatomical Mapping System With Fluoroscopy Integration Module.

Atrioventricular nodal reentrant tachycardia (AVNRT) is a common supraventricular tachycardia. Current guidelines recommend electrophysiology study (EPS) and ablation, which have been proven to show high success rates with very low complication rates. Usually, ablation of AVNRT is performed conventionally using only fluoroscopy.

Fast anatomical mapping of the carina and its implications for acute pulmonary vein isolation.

Background: Fast anatomical mapping (FAM) of the left atrium and pulmonary veins (PV) during PV isolation (PVI) generates anatomical information about the carina region additionally. We aimed to investigate the utility of these data in relation to conduction abilities of the intervenous carina.

Methods: We investigated 71 patients with drug-refractory atrial fibrillation (AF) who underwent first-time circumferential PVI using an electroanatomical mapping system.

Influence of excess weight and obesity on performance and outcome of pulmonary vein isolation with the cryoballoon.

Pulmonary vein isolation (PVI) has become a cornerstone therapy in the treatment of atrial fibrillation (AF). Patients with overweight or obesity suffer more often from AF, and studies investigating the safety and feasibility of PVI in these patients have shown varying results. In this study we analyzed PVI performed with the 2nd generation cryoballoon (CB) with regard to safety, procedure and fluoroscopy time in patients with normal weight, overweight and obesity.

Long-term impact of a bonus freeze on clinical outcome: Analysis of effective and non-effective bonus freezes in cryoballoon ablation.

Purpose: Data on bonus freeze characteristics and their impact on complication rates and long-term clinical outcome are limited.

Methods: Pulmonary vein isolation (PVI) using a 28 mm 2nd-generation cryoballoon (CB) was performed in 169 patients (pts). The isolation temperatures, time to isolation and minimal temperatures of the cryoapplications were documented.

Gender-based acute outcome in percutaneous coronary intervention of chronic total coronary occlusion.

Background: Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge. Insignificant data are reported in the literature about gender differences in CTO-PCI in the era of new drug-eluting stents. In this study we analysed the impact of gender on procedural characteristics, complications and acute results.

Pulmonary vein isolation in patients with paroxysmal atrial fibrillation : Long-term clinical outcomes with first- and second-generation cryoballoons.

Background: The aim of this study was to evaluate the long-term success rates of pulmonary vein isolation (PVI) using only first-generation cryoballoon (CB-1) and second-generation CB (CB-2) in patients with paroxysmal atrial fibrillation (PAF).

Patients And Methods: A total of 114 drug-refractory patients with PAF (mean age: 62 ± 10 years; 62.3 % males) were enrolled.

Cryoballoon ablation for pulmonary vein isolation in patients with atrial fibrillation: preliminary results using novel short-tip cryoballoon.

Purpose: In this study, we aimed to report our preliminary experience regarding the impact of the novel short-tip (ST) cryoballoon (CB) on procedural efficacy and signal quality during pulmonary vein (PV) isolation for both paroxysmal and persistent atrial fibrillation.

Methods: Between March, 2015, and August, 2015, we enrolled a total of 64 patients (47 patients male, 73 %) with a mean age of 60 ± 11 years. In the study population, 31 patients (48 %) underwent PVI using Advance (ADV) CB and 33 (52 %) patients with ST CB.

Characterization of Electrical Reconnection Following Pulmonary Vein Isolation Using First- and Second-Generation Cryoballoon.

Background: Second-generation cryoballoon (CB-2) is associated with improved outcomes for pulmonary vein isolation (PVI) compared to first generation (CB-1). However, data regarding the predictors of pulmonary vein (PV) electrical reconnection are limited. In this study, we aimed to characterize the predilection sites and predictors of reconnection in patients with recurrent atrial tachyarrhythmia (ATa) after PVI using CB-1 and CB-2.

The Total Incidence of Complications and the Impact of an Anticoagulation Regime on Adverse Events After Cryoballoon Ablation of Atrial Fibrillation: A Single-Center Study of 409 Patients.

Aim: Data evaluating the complications of pulmonary vein isolation (PVI) using second-generation cryoballoons (CB) related to different anticoagulation regimes are limited. This study evaluates the total complications and the impact of novel oral anticoagulants (NOACs) compared to phenprocoumon on adverse events in the setting of PVI using CB.

Methods And Results: PVI was performed using second-generation CB by two experienced investigators.

Role of diabetes in heart rhythm disorders.

The incidence of diabetes mellitus (DM) is increasing rapidly. DM is the leading cause of cardiovascular diseases, which can lead to varied cardiovascular complications by aggravated atherosclerosis in large arteries and coronary atherosclerosis, thereby grows the risk for macro and microangiopathy such as myocardial infarction, stroke, limb loss and retinopathy. Moreover diabetes is one of the strongest and independent risk factor for cardiovascular morbidity and mortality, which is associated frequently with rhythm disorders such as atrial fibrillation (AF) and ventricular arrhythmias (VA).

Rotational Angiography Based Three-Dimensional Left Atrial Reconstruction: A New Approach for Transseptal Puncture.

Aim: Rotational angiography is a well-known method for the three-dimensional (3-D) reconstruction of left atrium and pulmonary veins during left-sided atrial arrhythmia ablation procedures. In our study, we aimed to review our experience in transseptal puncture (TSP) using 3-D rotational angiography.

Methods: We included a total of 271 patients who underwent atrial fibrillation ablation using cryoballoon.

Cryoballoon Ablation for Pulmonary Vein Isolation in Patients With Persistent Atrial Fibrillation: One-Year Outcome Using Second Generation Cryoballoon.

Background: Data regarding the freedom from atrial fibrillation (AF) in the follow-up of persistent AF patients is limited. The second-generation cryoballoon has better cooling properties compared with first-generation cryoballon. In this study, we aimed to assess the medium-term efficacy of second-generation cryoballoon in patients with persistent AF.

Luminal esophageal temperature rise and esophageal lesion formation following remote-controlled magnetic pulmonary vein isolation.

Background: Remote magnetic pulmonary vein isolation (PVI) demonstrates comparable success rate to manual ablation, but thermal effects on esophageal tissue remain undefined.

Objective: The purpose of this study was to evaluate the potential thermal effects on esophageal tissue during remote magnetic wide-area circumferential pulmonary vein isolation (CPVI).

Methods: Twenty-five patients (23 men, age 57 ± 10 years) in the magnetic navigation system (MNS) group and 25 control subjects (15 men, age 61 ± 12 years) with drug-refractory paroxysmal or persistent atrial fibrillation underwent CPVI.

Cavotricuspid Isthmus Anatomy Determines The Success Of Remote Controlled Magnetic Bidirectional Block: A Comparsion Between Magnetic 8-mm Solid Tip And 3.5-mm Magnetic Irrigated Tip Catheter.

Background: Cavotricuspid isthmus (CTI) anatomy is associated with a great inter-individual variability. The aim of this study was to compare the magnetic 8-mm tip catheter versus the novel 3.5-mm magnetic irrigated tip catheter in achieving bidirectional right atrial isthmus block and to evaluate the impact of the underlying CTI anatomy on success rate.

Catheter ablation of right ventricular outflow tract tachycardia: a simplified remote-controlled approach.

Aims: Manual mapping and ablation of right ventricular outflow tract (RVOT) tachycardia may be associated with cardiac perforation and complicated by mechanically induced ventricular extrasystoles (VESs). The aim of this study was to assess remote-controlled magnetic (RCM) mapping and ablation of RVOT ventricular tachycardia (VT)/VES utilizing a soft magnetic catheter.

Methods And Results: Mapping and ablation of RVOT VT/VES were performed using the magnetic navigation system (MNS, Niobe II, Stereotaxis, St Louis, MO) in conjunction with a cardiodrive motor unit (Stereotaxis).

Catheter ablation for ventricular tachycardia after failed endocardial ablation: epicardial substrate or inappropriate endocardial ablation?

Background: The substrate of myocardial ventricular tachycardia (VT) may involve the subepicardial myocardium.

Objective: The purpose of this study was to assess the incidence of epicardial substrates in patients with a previously failed endocardial ablation attempt for VT as well as the safety and effectiveness of epicardial ablation.

Methods: Using an electroanatomic mapping system, endocardial and epicardial maps were acquired.

Remote-controlled magnetic pulmonary vein isolation using a new irrigated-tip catheter in patients with atrial fibrillation.

Background: Lack of an irrigated-tip magnetic catheter has limited the role of remote-controlled magnetic navigation (Niobe II, Stereotaxis) for catheter ablation of atrial fibrillation (AF).

Methods And Results: A novel 3.5-mm-tip irrigated magnetic catheter (group 1, Thermocool Navistar RMT, Biosense Webster) was used for 3D left atrial reconstruction (CARTO RMT) and remote-controlled magnetic pulmonary vein isolation.

Catheter ablation of long-standing persistent atrial fibrillation: a lesson from circumferential pulmonary vein isolation.

Introduction: Circumferential pulmonary vein isolation (CPVI) is associated with a high success rate in patients with paroxysmal and persistent atrial fibrillation (AF). However, in patients with long-standing persistent AF, the ideal ablation strategy still remains a matter of debate.

Methods And Results: Two-hundred and five patients underwent catheter ablation for long-standing persistent AF defined as continuous AF of more than 1-year duration.

Unexpected high incidence of esophageal injury following pulmonary vein isolation using robotic navigation.

Introduction: Robotic navigation (RN) is a novel technology for pulmonary vein isolation (PVI). We investigated the incidence of thermal esophageal injury using RN with commonly used power settings in comparison to manual PVI procedures. methods: Thirty-nine patients underwent circumferential PVI using a 3.

Long-term clinical outcome following pulmonary vein isolation with high-intensity focused ultrasound balloon catheters in patients with paroxysmal atrial fibrillation.

Aims: High-intensity focused ultrasound (HIFU) applied via a balloon catheter is a novel technology for pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF). The long-term success rate is unknown.

Methods And Results: Thirty-two patients (22 male, age 60 +/- 9 years) with a long history [5 (4;9) years] of drug refractory [3 +/- 1 anti-arrhythmic drugs (AADs)], symptomatic PAF were included into the analysis.

Right ventricular rapid pacing in catheter ablation of atrial fibrillation: a novel application for cryoballoon pulmonary vein isolation.

Background: Cryoballoon ablation (Arctic Front, Cryocath) represents a novel technology for pulmonary vein isolation (PVI). The initial phase of a freeze is crucial for cryolesion formation which is determined by local temperature depending on blood flow. We investigated the impact of right ventricular rapid pacing (RVRP) on temperature kinetics in patients (pts) with paroxysmal atrial fibrillation (PAF).