Best Practice Guide for Cryoballoon Ablation in Atrial Fibrillation: The Compilation Experience of More than 1000 Procedures.
Dimitrios TsiachrisChristos-Konstantinos AntoniouIoannis DoundoulakisPanagiota ManolakouDemetrios SougiannisAthanasios KordalisKonstantinos A GatzoulisGian-Battista ChierchiaCarlos De AsmundisChristodoulos StefanadisKonstantinos TsioufisPublished in: Journal of cardiovascular development and disease (2023)
Nowadays, the cryoballoon (CB) constitutes an established alternative to radio frequency (RF) ablation for pulmonary vein isolation (PVI), which offers the possibility to isolate the PVs with a single application. Since the introduction of the second-generation CB, we prospectively collected our data to optimize the procedure on >1000 consecutive patients who underwent CB PVI performed in our center. It is expected that subsequent guidelines will suggest first-line PVI through CB in patients with paroxysmal AF with a class I indication. Indeed, in the long-term follow-up (36 months) of the EARLY-AF trial, CB had a lower incidence of persistent atrial fibrillation episodes compared to the anti-arrhythmic drugs group. We now review the current best practices in an effort to drive consistent outcomes and minimize complications. PV isolation through CB is the most studied single-shot technique for atrial fibrillation ablation, having shown the potential to alter the natural history of the arrhythmia. Several procedural tips and tricks can improve procedural flow and effectiveness. In the present article we provided not only technical details but measurable biophysical parameters that can reliably guide the operator into achieving the best outcome for his patients.
Keyphrases
- atrial fibrillation
- catheter ablation
- left atrial
- end stage renal disease
- oral anticoagulants
- left atrial appendage
- ejection fraction
- healthcare
- heart failure
- primary care
- newly diagnosed
- direct oral anticoagulants
- chronic kidney disease
- clinical trial
- peritoneal dialysis
- radiofrequency ablation
- systematic review
- percutaneous coronary intervention
- randomized controlled trial
- prognostic factors
- insulin resistance
- left ventricular
- quality improvement
- clinical practice
- machine learning
- climate change
- artificial intelligence
- data analysis
- patient reported outcomes