Cryoballoon pulmonary vein isolation using a novel spiral catheter successfully isolated 54% of pulmonary veins, with shorter time to block predicting sustained isolation (33 vs 99 seconds).
Observational (n=18)
Does a novel spiral catheter allow feasible and safe real-time PV potential registration during cryoballoon pulmonary vein isolation?
Real-time visualization of pulmonary vein conduction during cryoballoon ablation using a novel spiral catheter is feasible and safe, with shorter time to conduction block predicting sustained isolation.
INTRODUCTION: Cryoballoon (CB) ablation represents a novel technology for pulmonary vein isolation (PVI). We investigated feasibility and safety of CB-PVI, utilizing a novel spiral catheter (SC), thereby obtaining real-time PV potential registration. METHODS: Following double transseptal puncture, a Lasso catheter (Biosense Webster, Diamond Bar, CA, USA) and the 28 mm CB were positioned within the left atrium. A novel SC (Promap, ProRhythm Inc., Ronkonkoma, NY, USA) was inserted through the lumen of the CB allowing PV signal registration during treatment. Time to PV conduction block was analyzed. If no stable balloon position was obtained, the SC was exchanged for a regular guide wire and PV conduction was assessed after treatment by Lasso catheter. RESULTS: In 18 patients, 39 of 72 PVs (54%) were successfully isolated using the SC. The remaining 33 PVs were isolated switching to the regular guide wire. Time to PV conduction block was significantly shorter in PVs in which sustained PVI was achieved as compared to PVs in which PV conduction recovered within 30 minutes (33 +/- 21 seconds vs 99 +/- 65 seconds). In 40 PVs, time to PV conduction block was not obtained because of: (1) PVI not being achieved during initial treatment; (2) a distal position of the SC; or (3) isolation with regular guide wire. No procedural complications occurred. CONCLUSION: Visualization of real-time PV conduction during CB PVI is safe, feasible, and allows accurate timing of PVI onset in a subset of PVs. Time to PV conduction block predicts sustained PVI. However, mechanical properties of the SC need to be improved to further simplify CB PVI.
Chun et al. (Mon,) conducted a observational in Pulmonary vein isolation (n=18). Cryoballoon pulmonary vein isolation with a novel spiral catheter was evaluated on Successful pulmonary vein isolation using the spiral catheter. Cryoballoon pulmonary vein isolation using a novel spiral catheter successfully isolated 54% of pulmonary veins, with shorter time to block predicting sustained isolation (33 vs 99 seconds).