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13.05.2022 | Original Article

Impact of cryoballoon contact angle and acute myocardial injury on pulmonary vein reconnection

verfasst von: Masamichi Yano, Yasuyuki Egami, Shodai Kawanami, Hiroki Sugae, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Yutaka Matsuhiro, Koji Yasumoto, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masami Nishino, Jun Tanouchi

Erschienen in: Heart and Vessels | Ausgabe 11/2022

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Abstract

At present, it remains unclear whether the effect on cryoinjury can be strongly exerted by contact of the balloon with the pulmonary vein (PV) ostium. The present study included 204 paroxysmal atrial fibrillation (PAF) patients who underwent an initial pulmonary vein isolation (PVI) using a cryoballoon from the Osaka Rosai Atrial Fibrillation ablation (ORAF) registry. The total balloon contact angle was measured from the equator line (sum of the angles of the upper side and bottom side in all PVs) under fluoroscopic imaging. The patients were stratified into three tertile groups according to the total balloon contact angle. We evaluated the relationship between the total balloon contact angle and clinical outcomes, including the value of acute myocardial injury marker (high-sensitive cardiac troponin I [hs-TnI]), arrhythmia recurrence, and PV reconnections in the repeated ablation. The total balloon contact angle was significantly associated with the hs-TnI value among the tertile groups (p < 0.001) and a multiple regression analysis showed that the total balloon contact angle significantly correlated with the hs-TnI value (standardized beta-coefficient = 0.572, p < 0.001). The balloon contact angle in PVs with PV reconnections was significantly lower than in those without (p = 0.044), while no significant differences in the recurrence of atrial fibrillation among the tertile groups were observed in the enrolled patients. The total balloon contact angle was significantly associated with the acute myocardial injury marker, hs-TnI. The total balloon contact angle was significantly associated with PV reconnections after cryoballoon ablation in patients who underwent a repeat ablation.

Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D (1998) Impact of atrial fibrillation on the risk of death: the Framingham heart study. Circulation 98:946–952CrossRef

Haïssaguerre M, Jaïs P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Métayer P, Clémenty J (1998) Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 339:659–666CrossRef

Kuck KH, Brugada J, Fürnkranz A, Metzner A, Ouyang F, Chun KR, Elvan A, Arentz T, Bestehorn K, Pocock SJ, Albenque JP, Tondo C (2016) Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation. N Engl J Med 374:2235–2245CrossRef

Ciconte G, Velagić V, Mugnai G, Saitoh Y, Irfan G, Hunuk B, Ströker E, Conte G, Sieira J, Di Giovanni G, Baltogiannis G, Brugada P, de Asmundis C, Chierchia GB (2016) Electrophysiological findings following pulmonary vein isolation using radiofrequency catheter guided by contact-force and second-generation cryoballoon: lessons from repeat ablation procedures. Europace 18:71–77CrossRef

Scala O, Borio G, Paparella G, Varnavas V, Ströker E, Guimaraes Osorio T, Terasawa M, Sieira J, Maj R, Rizzo A, Al-Hosari MM, Galli A, Brugada P, de Asmundis C, Chierchia GB (2020) Predictors of durable electrical isolation in the setting of second-generation cryoballoon ablation: a comparison between left superior, left inferior, right superior, and right inferior pulmonary veins. J Cardiovasc Electrophysiol 31:128–136CrossRef

Miyazaki S, Kajiyama T, Watanabe T, Nakamura H, Hachiya H, Tada H, Iesaka Y (2020) Predictors of durable pulmonary vein isolation after second-generation cryoballoon ablation with a single short freeze strategy—different criteria for the best freeze of the 4 individual PVs. Int J Cardiol 301:96–102CrossRef

Shah DC, Lambert H, Nakagawa H, Langenkamp A, Aeby N, Leo G (2010) Area under the real-time contact force curve (force-time integral) predicts radiofrequency lesion size in an in vitro contractile model. J Cardiovasc Electrophysiol 21:1038–1043CrossRef

Natale A, Reddy VY, Monir G, Wilber DJ, Lindsay BD, McElderry HT, Kantipudi C, Mansour MC, Melby DP, Packer DL, Nakagawa H, Zhang B, Stagg RB, Boo LM, Marchlinski FE (2014) Paroxysmal AF catheter ablation with a contact force sensing catheter: results of the prospective, multicenter SMART-AF trial. J Am Coll Cardiol 64:647–656CrossRef

Yano M, Egami Y, Yanagawa K, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Yamato M, Shutta R, Nishino M, Tanouchi J (2020) Comparison of myocardial injury and inflammation after pulmonary vein isolation for paroxysmal atrial fibrillation between radiofrequency catheter ablation and cryoballoon ablation. J Cardiovasc Electrophysiol 31:1315–1322CrossRef

10.

Yano M, Egami Y, Ukita K, Kawamura A, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Shutta R, Nishino M, Tanouchi J (2021) Impact of baseline right bundle branch block on outcomes after pulmonary vein isolation in patients with atrial fibrillation. Am J Cardiol 144:60–66CrossRef

11.

Yano M, Egami Y, Ukita K, Kawamura A, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Shutta R, Nishino M, Tanouchi J (2021) Impact of myocardial injury and inflammation due to ablation on the short-term and mid-term outcomes: cryoballoon versus laser balloon ablation. Int J Cardiol 338:102–108CrossRef

12.

Egami Y, Ukita K, Kawamura A, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Yano M, Shutta R, Nishino M, Tanouchi J (2021) Electrophysiological characteristics of atrial tachycardia after mitral valve surgery via a superior transseptal approach. Circ Arrhythm Electrophysiol 14:e009437CrossRef

13.

Tokutake K, Tokuda M, Yamashita S, Sato H, Ikewaki H, Okajima E, Oseto H, Yokoyama M, Isogai R, Yokoyama K, Kato M, Narui R, Tanigawa S, Matsuo S, Miyanaga S, Sugimoto K, Yoshimura M, Yamane T (2019) Anatomical and procedural factors of severe pulmonary vein stenosis after cryoballoon pulmonary vein ablation. JACC Clin Electrophysiol 5:1303–1315CrossRef

14.

Dai DF, Rabinovitch PS, Ungvari Z (2012) Mitochondria and cardiovascular aging. Circ Res 110:1109–1124CrossRef

15.

Piro M, Della Bona R, Abbate A, Biasucci LM, Crea F (2010) Sex-related differences in myocardial remodeling. J Am Coll Cardiol 55:1057–1065CrossRef

16.

Freda BJ, Tang WH, Van Lente F, Peacock WF, Francis GS (2002) Cardiac troponins in renal insufficiency: review and clinical implications. J Am Coll Cardiol 40:2065–2071CrossRef

17.

Oswald H, Gardiwal A, Lissel C, Yu H, Klein G (2007) Difference in humoral biomarkers for myocardial injury and inflammation in radiofrequency ablation versus cryoablation. Pacing Clin Electrophysiol 30:885–890CrossRef

18.

Kenigsberg DN, Martin N, Lim HW, Kowalski M, Ellenbogen KA (2015) Quantification of the cryoablation zone demarcated by pre- and postprocedural electroanatomic mapping in patients with atrial fibrillation using the 28 mm second-generation cryoballoon. Heart Rhythm 12:283–290CrossRef

19.

Kühne M, Suter Y, Altmann D, Ammann P, Schaer B, Osswald S, Sticherling C (2010) Cryoballoon versus radiofrequency catheter ablation of paroxysmal atrial fibrillation: biomarkers of myocardial injury, recurrence rates, and pulmonary vein reconnection patterns. Heart Rhythm 7:1770–1776CrossRef

20.

Barrio-Lopez MT, Sanchez-Quintana D, Garcia-Martinez J, Betancur A, Castellanos E, Arceluz M, Ortiz M, Nevado-Medina J, Garcia F, Almendral J (2020) Epicardial connections involving pulmonary veins: the prevalence, predictors, and implications for ablation outcome. Circ Arrhythm Electrophysiol 13:e007544CrossRef

21.

Iso K, Okumura Y, Watanabe I, Nagashima K, Sonoda K, Kogawa R, Sasaki N, Takahashi K, Kurokawa S, Nakai T, Ohkubo K, Hirayama A (2016) Wall thickness of the pulmonary vein-left atrial junction rather than electrical information as the major determinant of dormant conduction after contact force-guided pulmonary vein isolation. J Interv Card Electrophysiol 46:325–333CrossRef

22.

Hussein A, Das M, Riva S, Morgan M, Ronayne C, Sahni A, Shaw M, Todd D, Hall M, Modi S, Natale A, Dello Russo A, Snowdon R, Gupta D (2018) Use of ablation index-guided ablation results in high rates of durable pulmonary vein isolation and freedom from arrhythmia in persistent atrial fibrillation patients: the PRAISE study results. Circ Arrhythm Electrophysiol 11:e006576CrossRef

23.

Hirao T, Nitta J, Adachi A, Takahashi Y, Goya M, Hirao K (2018) First confirmation of histologic changes in the human heart after cryoballoon ablation. Heart Rhythm Case Rep 5:93–96

24.

Ukita K, Nakamura H, Matsuhiro Y, Yasumoto K, Yasumura K, Tanaka A, Matsunaga-Lee Y, Nakamura D, Yano M, Yamato M, Egami Y, Shutta R, Nishino M, Tanouchi J (2019) Postmortem late phase histopathology after pulmonary vein isolation using a cryoballoon: a case report. Pacing Clin Electrophysiol 42:1066–1068CrossRef

Titel: Impact of cryoballoon contact angle and acute myocardial injury on pulmonary vein reconnection
verfasst von: Masamichi Yano
Yasuyuki Egami
Shodai Kawanami
Hiroki Sugae
Kohei Ukita
Akito Kawamura
Hitoshi Nakamura
Yutaka Matsuhiro
Koji Yasumoto
Masaki Tsuda
Naotaka Okamoto
Yasuharu Matsunaga-Lee
Masami Nishino
Jun Tanouchi
Publikationsdatum: 13.05.2022
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 11/2022
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-022-02088-x

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