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Cryoballoon ablation during atrial fibrillation is associated with faster temperature drop and lower freezing temperatures

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Abstract

Purpose

Our aim was to analyse the temperature behaviour during second-generation cryoballoon ablation (CB-A) in patients with ongoing atrial fibrillation (AF) compared with those in sinus rhythm (SR).

Methods

Consecutive patients with drug-resistant AF who underwent pulmonary vein (PV) isolation by CB-A from April 2014 to May 2015 were analysed. The exclusion criteria were any contraindication for the procedure including the presence of an intracavitary thrombus, uncontrolled heart failure, contraindications to general anaesthesia and cardioversion to SR during the ablation procedure.

Results

A total amount of 323 consecutive patients having undergone PV isolation by means of CB-A (male 66 %, age 56.1 ± 13.4 years) was enrolled. During ablation in the left-sided PVs, time needed to reach −20°, −30° and −40° was significantly shorter in patients with AF than those in SR. During ablation in the right superior pulmonary vein (RSPV), time to reach −30° and −40° was also significantly longer in patients with AF; during ablation in the right inferior pulmonary vein (RIPV), although the temperature drop was faster in the AF group, times needed to reach −20°, −30° and −40° were not significantly prolonged compared with those in the SR group. Temperatures attained at 60 s, and minimal temperatures were also significantly lower in the AF group during all PV ablations except RIPV.

Conclusions

The temperature drop during AF cryoablation was significantly faster and attained significantly lower freezing degrees in patients with ongoing AF during the procedure compared with those in SR. This finding resulted markedly significant during each PV isolation except for RIPV cryoablation.

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Authors and Affiliations

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

    Giacomo Mugnai, Darragh Moran, Erwin Ströker, Diego Ruggiero, Hugo Enrique Coutino-Moreno, Ken Takarada, Valentina De Regibus, Rajin Choudhury, Pedro Brugada, Carlo de Asmundis & Gian-Battista Chierchia

  2. Electrophysiology Unit, Maria Cecilia Hospital, Cotignola, Italy

    Saverio Iacopino & Pasquale Filannino

  3. Department of Anaesthesiology, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium

    Vincent Umbrain & Stefan Beckers

Authors
  1. Giacomo Mugnai
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  2. Darragh Moran
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  3. Erwin Ströker
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  4. Diego Ruggiero
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  5. Hugo Enrique Coutino-Moreno
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  6. Ken Takarada
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  7. Valentina De Regibus
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  8. Rajin Choudhury
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  9. Saverio Iacopino
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  10. Pasquale Filannino
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  11. Vincent Umbrain
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  12. Stefan Beckers
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  13. Pedro Brugada
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  14. Carlo de Asmundis
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  15. Gian-Battista Chierchia
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Corresponding author

Correspondence to Giacomo Mugnai.

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Conflict of interest

GBC and CdA receive compensation for teaching purposes and proctoring from AF solutions, Medtronic. PB receives research grants on behalf of the centre and speaker’s fees from Medtronic. CdA is consultant for Daiichi Sankyo. GM received an educational grant from Medtronic for Postgraduate in Cardiac Electrophysiology and Pacing academic course.

Additional information

Giacomo Mugnai and Darragh Moran equally contributed as first co-authors.

Carlo de Asmundis and Gian-Battista Chierchia equally contributed as senior co-authors.

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Mugnai, G., Moran, D., Ströker, E. et al. Cryoballoon ablation during atrial fibrillation is associated with faster temperature drop and lower freezing temperatures. J Interv Card Electrophysiol 47, 357–364 (2016). https://doi.org/10.1007/s10840-016-0175-9

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  • DOI: https://doi.org/10.1007/s10840-016-0175-9

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