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Differential Expression of Adenine Nucleotide Converting Enzymes in Mitochondrial Intermembrane Space: A Potential Role of Adenylate Kinase Isozyme 2 in Neutrophil Differentiation
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      Time-to-Effect–Based Dosing Strategy for Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation : Results of the plusONE Multicenter Randomized Controlled Noninferiority Trial

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          Abstract

          The optimal dosage of cryotherapy during cryoballoon ablation of pulmonary veins is still unclear. This trial tested the noninferiority of a novel, individualized, cryotherapy-dosing strategy for each vein.

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          The ‘single big cryoballoon’ technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study

          Kyoung-Ryul Chun, Boris Schmidt, Andreas Metzner … (2008)
          Aims Cryothermal energy (CTE) ablation via a balloon catheter (Arctic Front, Cryocath™) represents a novel technology for pulmonary vein isolation (PVI). However, balloon-based PVI approaches are associated with phrenic nerve palsy (PNP). We investigated whether ‘single big cryoballoon’-deployed CTE lesions can (i) achieve acute electrical PVI without left atrium (LA) imaging and (ii) avoid PNP in patients with paroxysmal atrial fibrillation (PAF). Methods and results After double transseptal punctures, one Lasso catheter and a big 28 mm cryoballoon catheter using a steerable sheath were inserted into the LA. PV angiography and ostial Lasso recordings from all PVs were obtained. Selective PV angiography was used to evaluate balloon to LA–PV junction contact. CTE ablation lasted 300 s, and the PN was paced during freezing at right-sided PVs. Twenty-seven patients (19 males, mean age: 56 ± 9 years, LA size: 42 ± 5 mm) with PAF (mean duration: 6.6 ± 5.7 years) were included. PVI was achieved in 97/99 PVs (98%). Median (Q 1; Q 3) procedural, balloon, and fluoroscopy times were 220 min (190; 245), 130 min (90; 170), and 50 min (42; 69), respectively. Three transient PNP occurred after distal PV ablations. No PV stenosis occurred. Total median (Q 1; Q 3) follow-up time was 271 days (147; 356), and 19 of 27 patients (70%) remained in sinus rhythm (3-month blanking period). Conclusion Using the single big cryoballoon technique, almost all PVs (98%) could be electrically isolated without LA imaging and may reduce the incidence of PNP as long as distal ablation inside the septal PVs is avoided.
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            Individualized cryoballoon energy pulmonary vein isolation guided by real-time pulmonary vein recordings, the randomized ICE-T trial

            K.R. Chun, Marie Stich, Alexander Fürnkranz … (2017)
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              On the Quest for the Best Freeze: Predictors of Late Pulmonary Vein Reconnections After Second-Generation Cryoballoon Ablation.

              Giuseppe Ciconte, Giacomo Mugnai, Juan Sieira … (2015)
              The second-generation cryoballoon is effective in achieving acute pulmonary vein isolation (PVI) and favorable clinical outcome. To date, no data are available on factors affecting late PV reconnection after second-generation cryoballoon ablation.
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                Author and article information

                Journal
                Title: Circulation: Arrhythmia and Electrophysiology
                Abbreviated Title: Circ Arrhythm Electrophysiol
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Print): 1941-3149
                ISSN (Electronic): 1941-3084
                Publication date Created: December 2017
                Publication date (Print): December 2017
                Volume: 10
                Issue: 12
                Affiliations
                [1 ]From the Department of Cardiology, Arrhythmia Unit, INCLIVA Foundation, Hospital Clínico Universitario, Valencia, Spain (A.F.-d.-L.-O., M.I.-d.-F, A.M., P.L.-M., C.N., L.B.-S., J.M.S.-G., F.J.C.-G., R.R.-G.); Department of Cardiology, Arrhythmia Unit, Hospital General Universitario, Valencia, Spain (A.G.-F., A.I.-C., M.A.-F., J.G.M.-M.); and Department of Cardiology, Arrhythmia Unit, Hospital Universitario de San Juan, Alicante, Spain (J.C.-C., J.M.-A., V.B.-G.).
                Article
                DOI: 10.1161/CIRCEP.117.005318
                PubMed ID: 29247029
                SO-VID: 177fa22a-4da4-4d77-a09b-624cbcd1dc7b
                Copyright © © 2017
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