Right ventricular rapid pacing in catheter ablation of atrial fibrillation: a novel application for cryoballoon pulmonary vein isolation.
Clin Res Cardiol
; 98(8): 493-500, 2009 Aug.
Article
em En
| MEDLINE
| ID: mdl-19513775
BACKGROUND: Cryoballoon ablation (Arctic Front, Cryocath) represents a novel technology for pulmonary vein isolation (PVI). The initial phase of a freeze is crucial for cryolesion formation which is determined by local temperature depending on blood flow. We investigated the impact of right ventricular rapid pacing (RVRP) on temperature kinetics in patients (pts) with paroxysmal atrial fibrillation (PAF). METHODS AND RESULTS: Right ventricular rapid pacing was performed from the RV apex. Absolute minimal temperature (MT, degrees C), temperature slopes [time (s) to 80% MT; dT/dt), area under the curve (AUC) and arterial blood pressure (ABP, mmHg) were compared (group I: with RVRP vs. group II: without RVRP). RVRP (mean duration 55 +/- 7 s) was performed in 11 consecutive PAF pts (41 PVs, age 58 +/- 9 years, LA size 44 +/- 6 mm, normal ejection fraction). Only freezes with identical balloon positions were analyzed (11/41 PVs). RVRP (cycle length 333 +/- 3 ms) induced a significant drop in ABP (group I: 45 +/- 3 mmHg vs. group II: 100 +/- 18 mmHg, p < 0.001). MT was not different between group I and group II (-45.0 +/- 4.4 vs. -44.3 +/- 3.4 degrees C, p = 0.46), whereas slope (38.0 +/- 4.6 s vs. 51.6 +/- 14.4 s, p = 0.0034) and AUC (1090 +/- 4.6 vs. 1181 +/- 111.2, p = 0.02) was significantly changed. In one pt, a ventricular tachycardia was induced. PVI was achieved in 41/41 PVs. CONCLUSION: Right ventricular rapid pacing significantly accelerates cryoballoon cooling during the initial phase of a freeze possibly suggesting improved cryolesions.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veias Pulmonares
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Fibrilação Atrial
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Cateterismo
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Criocirurgia
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Sistema de Condução Cardíaco
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Ventrículos do Coração
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Clin Res Cardiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Alemanha
País de publicação:
Alemanha