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Improved visualisation of real-time recordings during third generation cryoballoon ablation: a comparison between the novel short-tip and the second generation device

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Abstract

Background

The third-generation Cryoballoon Advance Short-tip (CB-ST) has been designed with a 40 % shortened tip length compared with the former second generation CB advance device (CB-A). Ideally, a shorter tip should permit an improved visualisation of real-time recordings in the pulmonary vein (PV) due to a more proximal positioning of the inner lumen mapping catheter. We sought to compare the incidence of visualisation of real-time recordings in patients having undergone ablation with the CB-ST with patients having received CB-A ablation.

Methods

All patients having undergone CB ablation using CB-ST technology and the last 500 consecutive patients having undergone CB-A ablation were analysed. Exclusion criteria were the presence of an intracavitary thrombus, uncontrolled heart failure, moderate or severe valvular disease, and contraindications to general anaesthesia.

Results

A total of 600 consecutive patients (58.1 ± 12.9 years, 64 % males) were evaluated (100 CB-ST and 500 CB-A ablations). Real-time recordings were significantly more prevalent in the CB-ST population compared with CB-A group (85.7 vs 67.2 %, p < 0.0001). Real-time recordings could be more frequently visualised in the CB-ST group in all types of veins (LSPV 89 vs 73.4 %, p = 0.0005; LIPV 84 vs 65.6 %, p = 0.0002; RSPV 87 vs 67.4 %, p < 0.0001; RIPV 83 vs 62.4 %, p < 0.0001).

Conclusion

The rate of visualisation of real-time recordings is significantly higher during third-generation CB-ST ablation if compared to the second-generation CB-A device. Real-time recordings can be visualised in approximately 85.7 % of veins with this novel cryoballoon.

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Acknowledgments

GBC and CdA receive compensation for teaching purposes and proctoring from AF solutions, Medtronic. PB receives research grants on behalf of the centre from Biotronik, Medtronic, St Jude Medical, Sorin, Boston Scientific and speakers fees from Biosense-Webster, Biotronik, Medtronic. CdA is consultant for Daiichi Sankyo. GM is currently receiving an educational grant from Medtronic for Postgraduate in Cardiac Electrophysiology and Pacing academic course.

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    Authors and Affiliations

    1. Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium

      Giacomo Mugnai, Carlo de Asmundis, Burak Hünük, Erwin Ströker, Darragh Moran, Ebru Hacioglu, Diego Ruggiero, Hugo Enrique Coutino-Moreno, Ken Takarada, Valentina de Regibus, Pedro Brugada & Gian-Battista Chierchia

    2. Department of Anaesthesiology, UZ Brussel-VUB, Brussels, Belgium

      Jan Poelaert, Christian Verborgh, Vincent Umbrain & Stefan Beckers

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    1. Giacomo Mugnai
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    Correspondence to Giacomo Mugnai.

    Additional information

    Giacomo Mugnai and Carlo de Asmundis contributed equally to this work.

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    Mugnai, G., de Asmundis, C., Hünük, B. et al. Improved visualisation of real-time recordings during third generation cryoballoon ablation: a comparison between the novel short-tip and the second generation device. J Interv Card Electrophysiol 46, 307–314 (2016). https://doi.org/10.1007/s10840-016-0114-9

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