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Pulmonary Vein Isolation Using the First‐Generation Cryoballoon Technique in Chinese Patients
Author(s) -
ZHOU GONGBU,
GUO XIAOGANG,
LIU XU,
YANG JIANDU,
SUN QI,
MA JIAN,
ZHANG SHU
Publication year - 2015
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12675
Subject(s) - medicine , pulmonary vein , balloon , atrial fibrillation , fluoroscopy , ablation , catheter ablation , cardiology , catheter , nuclear medicine , surgery
Background Cryoballoon ablation is an alternative for the treatment of atrial fibrillation (AF). We assess the relationship among pulmonary vein (PV) electrophysiology, balloon temperature, and persistent PV isolation (PVI), and report procedural properties, safety, and efficacy of this technique in a Chinese center for the first time. Methods A total of 70 patients with paroxysmal (n = 57) and persistent (n = 13) AF were consecutively enrolled. PVI was performed with cryoballoon catheter. Real‐time recording of dissociation of PV potentials was attempted using a circumferential mapping catheter. Results Successful PVI was achieved in 274 of 282 (97.2%) PVs. Procedural duration was 115.2 ± 24.8 minutes and fluoroscopy time was 29.6 ± 8.9 minutes. Real‐time PV potential recording was achieved in 232 (84.3%) PVs. Regarding time to isolation, a cut‐off value of less than 60 seconds was predictive of persistent PVI with a sensitivity of 0.76 and specificity of 0.82 (area under curve = 0.835; P < 0.0001). The nadir balloon temperature was significantly lower in PVs without early reconduction (–46.3 ± 0.5°C vs –40.2 ± 1.3°C, P < 0.0001). However, there was an insignificant trend that the balloon temperature at isolation was higher in PVs without reconduction (–33.9 ± 0.7°C vs –36.4 ± 2.0°C, P = 0.14). The overall complication rate was 5.7%. After a median follow‐up of 6.5 (range 3.2–14.9) months, 76% of patients were free of AF recurrence with a blanking period of 3 months. Conclusions Real‐time PV potentials can be recorded in most PVs. The time to isolation is predictive of the persistency of PVI. The nadir balloon temperature, not the balloon temperature at isolation, is significantly lower in PVs without reconduction.