Compound motor action potential guided 240 seconds plus bonus Freeze for safe and durable left atrial appendage isolation in patient with recurrent persistent atrial fibrillation: How to isolate the appendage with cryo-balloon (The CMAP guided ICE-B proto

2019 ◽  
Vol 30 (7) ◽  
pp. 1176-1176
Author(s):  
Pietro Turco
Keyword(s):  
Atrial Fibrillation ◽  
Action Potential ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Persistent Atrial Fibrillation ◽  
Atrial Appendage ◽  
Motor Action ◽  
Compound Motor Action Potential ◽  
Left Atrial Appendage Isolation

scholarly journals Long-standing Persistent Atrial Fibrillation Ablation in a Patient With High Risk of Bleeding

2020 ◽  
Vol 33 (2) ◽  
pp. 115-121
Author(s):  
Cristiano Pisani ◽  
Muhieddine Chokr ◽  
Carina Hardy ◽  
Sissy Lara ◽  
Mauricio Scanavacca
Keyword(s):  
Atrial Fibrillation ◽  
High Risk ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Persistent Atrial Fibrillation ◽  
Posterior Wall ◽  
Atrial Appendage ◽  
Risk Of Bleeding ◽  
Left Atrial Appendage Occlusion ◽  
Left Atrial Appendage Isolation

A 57 year-old patient with dilated cardiomyopathy, long-standing persistent atrial fibrillation, heart failure and episodes of gastrointestinal bleeding underwent AF ablation with pulmonary vein isolation, homogeneization of septal scar, posterior wall isolation and also left atrial appendage isolation. Additionally, because of the high risk of embolism, underwent left atrial appendage occlusion.

Masked left atrial appendage isolation during ablation of persistent atrial fibrillation

Heart Rhythm ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 137-141 ◽  
Author(s):  
Dionyssios Leftheriotis ◽  
Yasuhiro Yoshiga ◽  
Karl-Heinz Kuck ◽  
Feifan Ouyang
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Persistent Atrial Fibrillation ◽  
Atrial Appendage ◽  
Left Atrial Appendage Isolation

Long-term outcomes of cryoballoon-based left atrial appendage isolation in addition to pulmonary vein isolation in persistent atrial fibrillation

EP Europace ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. 1653-1662 ◽  
Author(s):  
Hikmet Yorgun ◽  
Uğur Canpolat ◽  
Metin Okşul ◽  
Yusuf Ziya Şener ◽  
Ahmet Hakan Ateş ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Persistent Atrial Fibrillation ◽  
Atrial Appendage ◽  
Left Atrial Appendage Isolation

Abstract Aims Pulmonary vein isolation (PVI) alone in persistent atrial fibrillation (AF) is not as successful as in paroxysmal AF, and recent data indicate the key role of non-PV triggers. We aimed to assess the long-term safety and efficacy of left atrial appendage isolation (LAAi) as an adjunct to PVI using cryoballoon (CB) in persistent AF. Methods and results We compared 144 persistent AF patients (59 ± 10 years, 51% females) who underwent PVI combined with LAAi with a propensity-score matched cohort of 138 persistent AF patients (59 ± 6 years, 52% female) in whom PVI-only was performed. Baseline and follow-up data including electrocardiography (ECG), 24-h Holter ECG’s, and echocardiography were recorded for all patients. Atrial tachyarrhythmia (ATa) recurrence was defined as detection of AF, atrial flutter, or atrial tachycardia (≥30 s) after a 3-month blanking period. At a mean of 30.5 ± 5.6 months follow-up, 85 (61.6%) patients in the PVI-only group and 109 (75.7%) patients in the PVI+LAAi group were free of ATa after the index procedure (P = 0.008). Ischaemic stroke/transient ischaemic attack was detected in 4 (2.9%) patients in PVI-only group and in 5 (3.5%) patients in the PVI+LAAi group (P = 0.784). Cox regression analysis revealed that the PVI-only strategy was found as a significant predictor for recurrence (hazard ratio 3.01, 95% confidence interval 1.81–5.03; P < 0.001). Conclusions Our findings indicated that CB-based LAAi+PVI was associated with a favourable efficacy compared to PVI-only strategy in patients with persistent AF. Although ischaemic event rates were similar between the groups, rigorous adherence to anticoagulation regime is paramount in order to prevent thrombo-embolic complications.

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