Occlusion tool software for pulmonary vein occlusion verification in atrial fibrillation cryoballoon ablation.
Atrial Fibrillation
/ diagnostic imaging
Cardiac Catheterization
Coronary Angiography
Cryosurgery
/ instrumentation
Epicardial Mapping
Feasibility Studies
Female
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Prospective Studies
Pulmonary Veins
/ diagnostic imaging
Sensitivity and Specificity
Software
atrial fibrillation
cryoablation
new dielectric imaging system
occlusion tool
pulmonary vein isolation
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
12
05
2020
revised:
21
10
2020
accepted:
15
11
2020
pubmed:
20
11
2020
medline:
20
11
2021
entrez:
19
11
2020
Statut:
ppublish
Résumé
Optimal pulmonary vein (PV) occlusion, usually verified with selective contrast injection, is mandatory to obtain an effective PV isolation during cryoballoon (CB) ablation. The purpose of this study was to verify the feasibility and the accuracy of a new dielectric sensing system in assessing PV occlusion during CB ablation in patients with atrial fibrillation (AF). We enrolled 28 consecutive patients with paroxysmal or persistent AF. After transseptal access, a detailed image reconstruction of left atrium and PVs was achieved with an octapolar or decapolar mapping catheter (Achieve catheter, Medtronic Inc.) and KODEX-EPD system (EPD Solutions, a Philips company). The degree of PV occlusion with the inflated Arctic Front Advance Cryoballoon (Medtronic Inc.) was verified using the new "occlusion tool" software module (EPD Solutions, a Philips company) and compared to an angiogram obtained with contrast medium injection in each PV. A total of 105 PV CB occlusion were tested. The new occlusion tool software module showed a 91% sensitivity and 76% specificity in assessing a complete PV occlusion verified with contrast medium injection. The positive predictive value was 80%, and the negative predictive value was 88.6%. Mean procedure time was 81 ± 17 minutes. Mean fluoroscopy time was 6 ± 2 minutes. No 30-day complications were observed. The new dielectric imaging system was able to assess the degree of PV occlusion during a CB ablation with good sensitivity and specificity.
Sections du résumé
BACKGROUND
Optimal pulmonary vein (PV) occlusion, usually verified with selective contrast injection, is mandatory to obtain an effective PV isolation during cryoballoon (CB) ablation.
AIM OF THE STUDY
The purpose of this study was to verify the feasibility and the accuracy of a new dielectric sensing system in assessing PV occlusion during CB ablation in patients with atrial fibrillation (AF).
METHODS
We enrolled 28 consecutive patients with paroxysmal or persistent AF. After transseptal access, a detailed image reconstruction of left atrium and PVs was achieved with an octapolar or decapolar mapping catheter (Achieve catheter, Medtronic Inc.) and KODEX-EPD system (EPD Solutions, a Philips company). The degree of PV occlusion with the inflated Arctic Front Advance Cryoballoon (Medtronic Inc.) was verified using the new "occlusion tool" software module (EPD Solutions, a Philips company) and compared to an angiogram obtained with contrast medium injection in each PV.
RESULTS
A total of 105 PV CB occlusion were tested. The new occlusion tool software module showed a 91% sensitivity and 76% specificity in assessing a complete PV occlusion verified with contrast medium injection. The positive predictive value was 80%, and the negative predictive value was 88.6%. Mean procedure time was 81 ± 17 minutes. Mean fluoroscopy time was 6 ± 2 minutes. No 30-day complications were observed.
CONCLUSION
The new dielectric imaging system was able to assess the degree of PV occlusion during a CB ablation with good sensitivity and specificity.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
63-70Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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