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

• Published in: Journal of interventional cardiac electrophysiology Vol. 46; no. 3; pp. 307 - 314
• Main Authors: Mugnai, Giacomo, de Asmundis, Carlo, Hünük, Burak, Ströker, Erwin, Moran, Darragh, Hacioglu, Ebru, Ruggiero, Diego, Poelaert, Jan, Verborgh, Christian, Umbrain, Vincent, Beckers, Stefan, Coutino-Moreno, Hugo Enrique, Takarada, Ken, de Regibus, Valentina, Brugada, Pedro, Chierchia, Gian-Battista
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2016; Springer Nature B.V
• Subjects: Aged; Atrial Fibrillation - diagnosis; Atrial Fibrillation - surgery; Body Surface Potential Mapping - instrumentation; Body Surface Potential Mapping - methods; Cardiology; Catheter Ablation - instrumentation; Catheter Ablation - methods; Computer Systems; Cryosurgery - instrumentation; Cryosurgery - methods; Equipment Design; Equipment Failure Analysis; Female; Humans; Image Enhancement - instrumentation; Male; Medicine; Medicine & Public Health; Reproducibility of Results; Sensitivity and Specificity; Surgery, Computer-Assisted - instrumentation; Surgery, Computer-Assisted - methods; Treatment Outcome; User-Computer Interface; Cryoballoon; Atrial fibrillation; Catheter ablation; Short tip; Pulmonary vein isolation
• ISSN: 1383-875X; 1572-8595
• DOI: 10.1007/s10840-016-0114-9

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.