A novel cryoballoon technique for mapping and isolating pulmonary veins: a feasibility and efficacy study.
BACKGROUND
The study was designed to evaluate the feasibility and efficacy of a simplified cryoballoon technique in which a microcircular catheter was introduced into the central lumen of a cryoballoon catheter for the purpose of recording pulmonary vein (PV) potentials during ablation procedures and without interchanging catheters.


RESULTS
A total of 23 consecutive patients with paroxysmal atrial fibrillation (AF) were enrolled. A single transseptal puncture was made and a cryoballoon catheter was inserted into the left atrium. A 6-pole mapping catheter with a 0.035-inch shaft diameter was introduced into the PV through the central lumen of the cryoballoon catheter. In addition to the function as a recording device, the mapping catheter was also used as a "guide-wire" during the procedure. A total of 84 PVs (84/92, 91.3%) were completely isolated using this novel cryoballoon technique. In 43 of the 84 veins (51.2%), isolation was observed in real time during the cryoablation; in the remaining 41 veins (48.8%), isolation was confirmed immediately post ablation attempt with the mapping catheter. Procedure time was 152.7 +/- 54.9 minutes, and fluoroscopy time was 33.2 +/- 17.3 minutes. At follow-up (7.4 months, range 2-18 months), 17 (73.9%) patients were free from AF. There was 1 occurrence of phrenic nerve palsy during ablation of a right superior PV, which fully resolved after 1 month.


CONCLUSIONS
The use of a cryoballoon catheter equipped with a 6-pole micromapping catheter inserted through its central lumen for the purpose of mapping and ablation during PV isolation procedures is both feasible and effective.
Tang
Min
M
Department of Internal Medicine/Cardiology, German Heart Institute Berlin, Berlin, Germany.
Kriatselis
Charalampos
C
Nedios
Sotiris
S
Ye
Gang
G
Roser
Mathias
M
Fleck
Eckard
E
Gerds-Li
Jin-Hong
JH
D000368:Aged; D001281:Atrial Fibrillation / Q000473:pathology / Q000601:surgery; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods*; D015331:Cohort Studies; D003080:Cold Temperature; D003452:Cryosurgery / Q000379:methods*; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011667:Pulmonary Veins / Q000033:anatomy & histology*; D016896:Treatment Outcome