Journal of Interventional Cardiac Electrophysiology

Erschienen in:

02.01.2020

Clinical impact of rapid ventricular pacing on the left atrial posterior wall isolation by a cryoballoon application: a randomized controlled trial

verfasst von: Takuro Nishimura, Kaoru Okishige, Yasuteru Yamauchi, Takatoshi Shigeta, Rena Nakamura, Tastuhiko Hirao, Tetsuo Sasano, Kenzo Hirao

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 3/2020

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Abstract

Purpose

Rapid ventricular pacing (RVP) was reported to improve the cooling effects of the cryoballoon (CB). The aim of this study was to investigate the safety and efficacy of RVP for left atrial posterior wall isolation (PWI) by the CB.

Methods

One hundred consecutive patients (males 80, mean age 63 ± 10 years) with persistent atrial fibrillation underwent left atrial roof (LA-RB) and bottom block line (LA-BB) creation by CB to achieve PWI. Patients were randomized into two groups according to whether they underwent PWI with (RVP group, n = 50) or without RVP (control group, n = 50).

Results

The nadir CB temperature (NCT) during the LA-RB and LA-BB creation was significantly lower in the RVP group than control group (LA-RB − 45.7 °C and − 43.9 °C, p < 0.001, and LA-BB − 42.4 °C and − 40.0 °C, p < 0.001). The success rate of the LA-RB creation was significantly higher in the RVP group than the control group (98% vs. 88%, p = 0.039), however, there were no significant differences regarding the LA-BB creation (66% vs. 52%, p = 0.15) and PWI (66% vs. 50%, p = 0.1) between the two groups. The PWI success rate did not differ whether CB freezing was prematurely terminated due to an excessive luminal esophageal temperature (LET) drop in the RVP group (65.8% vs. 66.7%, respectively, p = 0.96).

Conclusions

RVP significantly decreased the NCT during the CB application resulting in the significant improvement of success rate of the LA-RB. The advantage of RVP in terms of the accomplishing PWI was not affected even when the CB freezing was prematurely terminated due to an excessive LET drop.

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Titel: Clinical impact of rapid ventricular pacing on the left atrial posterior wall isolation by a cryoballoon application: a randomized controlled trial
verfasst von: Takuro Nishimura
Kaoru Okishige
Yasuteru Yamauchi
Takatoshi Shigeta
Rena Nakamura
Tastuhiko Hirao
Tetsuo Sasano
Kenzo Hirao
Publikationsdatum: 02.01.2020
Verlag: Springer US
Erschienen in: Journal of Interventional Cardiac Electrophysiology / Ausgabe 3/2020
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-019-00641-9

Use of a radiofrequency guidewire to simplify workflow for left atrium access: a case series

Transesophageal Echocardiography

An unusual response of pulmonary vein bigeminy to antral ablation

Case Reports

One-year outcomes after pulmonary vein isolation plus posterior wall isolation and additional non-pulmonary vein trigger ablation for persistent atrial fibrillation with or without contact force sensing: a propensity score-matched comparison

Reduction of radiation and contrast agent exposure in a cryoballoon ablation procedure with integration of electromagnetic mapping and intracardiac echocardiography: a single center experience

Image-guided ablation of scar-related ventricular tachycardia: towards a shorter and more predictable procedure

Signal- or temperature-based approach for cryoballoon ablation of atrial fibrillation: still an unsolved issue

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Clinical impact of rapid ventricular pacing on the left atrial posterior wall isolation by a cryoballoon application: a randomized controlled trial