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Impact of a time-to-effect guided ablation protocol in cryoballoon ablation on durability of pulmonary vein isolation
  • +11
  • Enida Rexha,
  • Christian Heeger,
  • Sabrina Maack,
  • Laura Rottner,
  • Peter Wohlmuth,
  • Christine Lemes,
  • Tilman Maurer,
  • Bruno Reissmann,
  • Andreas Rillig,
  • Shibu Mathew,
  • Christian Sohns,
  • Feifan Ouyang,
  • Karl-Heinz Kuck,
  • Andreas Metzner
Enida Rexha
Asklepios Klinik Sankt Georg

Corresponding Author:[email protected]

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Christian Heeger
Universitätsklinikum Schleswig-Holstein Campus Lübeck
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Sabrina Maack
Asklepios Klinik Sankt Georg
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Laura Rottner
University Medical Center Hamburg-Eppendorf University Heart & Vascular Center
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Peter Wohlmuth
Asklepios Klinik Sankt Georg
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Christine Lemes
Asklepios Klinik Sankt Georg
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Tilman Maurer
Asklepios Klinik Sankt Georg
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Bruno Reissmann
Universitätsklinikum Hamburg Eppendorf Universitäres Herzzentrum Hamburg GmbH
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Andreas Rillig
Universitätsklinikum Hamburg Eppendorf Universitäres Herzzentrum Hamburg GmbH
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Shibu Mathew
University Hospitals Giessen and Marburg Campus Giessen
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Christian Sohns
Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
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Feifan Ouyang
Universitätsklinikum Hamburg Eppendorf Universitäres Herzzentrum Hamburg GmbH
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Karl-Heinz Kuck
Universitätsklinikum Schleswig-Holstein Campus Lübeck
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Andreas Metzner
Universitätsklinikum Hamburg Eppendorf Universitäres Herzzentrum Hamburg GmbH
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Abstract

Background: Cryoballoon (CB) based pulmonary vein isolation (PVI) has proven to be as effective as radiofrequency (RF) based ablation. Different ablation protocols took the individual time-to-isolation (TTI) into account aiming at shorter but equally or even more effective freeze-cycles. The current study sought to assess the impact of the TTI on PVI durability in patients undergoing a repeat procedure for recurrence of atrial tachyarrhythmia (ATA). Methods and Results: In 205 patients with ATA recurrence after previous CB-based PVI a total of 806 PVs were identified. One hundred-twenty-six out of 806 PVs (16%) were previously treated with a TTI guided ablation (protocol #1; TTI+120 sec.), in 92/806 (11%) PVs TTI was only monitored (m) but fixed freeze-cycles were applied (protocol #2; mTTI) and in 588/806 (73%) a fixed freeze-cycle was applied without TTI-monitoring. There was no difference in the PV-reconduction rate between the groups (P=0.23). The right inferior pulmonary vein (RIPV) showed overall significantly higher reconduction rates compared to the other PVs (RIPV – left inferior PV (LIPV) p<0.003, -left superior PV (LSPV) p<0.001, - right superior PV RSPV p<0.013). In 21 patients (10%) only for the RIPV reconduction was assessed. Conclusions: TTI based CB ablation did not show significant differences regarding PV-reconduction rates compared to the other protocols.
29 Sep 2021Submitted to Journal of Cardiovascular Electrophysiology
06 Oct 2021Submission Checks Completed
06 Oct 2021Assigned to Editor
07 Oct 2021Reviewer(s) Assigned
22 Nov 2021Review(s) Completed, Editorial Evaluation Pending
22 Nov 2021Editorial Decision: Revise Minor
09 Jan 20221st Revision Received
10 Jan 2022Submission Checks Completed
10 Jan 2022Assigned to Editor
10 Jan 2022Reviewer(s) Assigned
29 Jan 2022Review(s) Completed, Editorial Evaluation Pending
30 Jan 2022Editorial Decision: Accept
Jun 2022Published in Journal of Cardiovascular Electrophysiology volume 33 issue 6 on pages 1096-1103. 10.1111/jce.15453