What question did this study set out to answer?

To assess whether transesophageal echocardiography (TEE) monitoring of mechanical pulmonary vein occlusion with color Doppler can predict effective electrical isolation during cryoballoon ablation.

June 26, 2009Journal of Cardiovascular Electrophysiology

Cryoballoon Pulmonary Vein Isolation Guided by Transesophageal Echocardiography: Novel Aspects on an Emerging Ablation Technique

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Why the study?

Does TEE-guided mechanical occlusion during cryoballoon ablation predict effective electrical isolation in patients with atrial fibrillation?

Population

30 patients (124 pulmonary veins) undergoing percutaneous treatment for atrial fibrillation (AF).

Design

Cohort

Follow-up

mean 7.4 +/- 3.7 months

Authors

CHClaudia Herrera‐SiklodyElectrophysiology JMJan MinnersStructural Heart Disease MAMartin AllgeierUniversitäts-Herzzentrum Freiburg-Bad Krozingen

Discussion

Member takes

Implication

Supports TEE-guided PV occlusion assessment in cryoballoon ablation; leaves open randomized validation before practice change.

Key Points

To assess whether transesophageal echocardiography (TEE) monitoring of mechanical pulmonary vein occlusion with color Doppler can predict effective electrical isolation during cryoballoon ablation.
Evaluated 124 pulmonary veins (PVs) across N=30 patients undergoing cryoballoon ablation under continuous TEE guidance.
Used color Doppler to confirm PV occlusion and evaluated final electrical isolation using a circumferential mapping catheter, following patients for a mean of 7.4 ± 3.7 months.
TEE visualized 123 of 124 PVs (99.2%), with complete antral visualization in 64.5% (80/124), partial in 29.0% (36/124), and proximal flow cessation in 5.7% (7/124).
Vein occlusion was achieved in 90.2% (111/123) of visualized PVs, yielding a positive predictive value for electrical isolation of 98.2% (109/111) and a negative predictive value of 91.7% (11/12, P < 0.001).
After 7.4 ± 3.7 months of follow-up, 73.3% of patients maintained sinus rhythm without antiarrhythmic medications.

Structured PICO

Does TEE-guided mechanical occlusion during cryoballoon ablation predict effective electrical isolation in patients with atrial fibrillation?

Population

30 patients (124 pulmonary veins) undergoing percutaneous treatment for atrial fibrillation (AF).

Intervention

Cryoballoon pulmonary vein isolation guided by continuous transesophageal echocardiography (TEE) with color Doppler to monitor mechanical occlusion.

Outcome

Effective electrical isolation evaluated using a circumferential mapping catheter at the end of the procedure.surrogate

TEE-guided color Doppler documentation of pulmonary vein occlusion during cryoballoon ablation is highly predictive of effective electrical isolation.

Cite This Study

Herrera‐Siklody et al. (2009) studied this question.

synapsesocial.com/papers/6a0f2b80a00258d2006ca12d https://doi.org/10.1111/j.1540-8167.2009.01524.x

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes

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Cryoballoon Pulmonary Vein Isolation Guided by Transesophageal Echocardiography: Novel Aspects on an Emerging Ablation Technique

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Cryoballoon Pulmonary Vein Isolation Guided by Transesophageal Echocardiography: Novel Aspects on an Emerging Ablation Technique

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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