Mugnai Giacomo, de Asmundis Carlo, Hünük Burak, Ströker Erwin, Moran Darragh, Hacioglu Ebru, Ruggiero Diego, Poelaert Jan, Verborgh Christian, Umbrain Vincent, Beckers Stefan, Coutino-Moreno Hugo Enrique, Takarada Ken, de Regibus Valentina, Brugada Pedro, Chierchia Gian-Battista
Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
Department of Anaesthesiology, UZ Brussel-VUB, Brussels, Belgium.
J Interv Card Electrophysiol. 2016 Sep;46(3):307-14. doi: 10.1007/s10840-016-0114-9. Epub 2016 Feb 12.
The third-generation Cryoballoon Advance Short-tip (CB-ST) has been designed with a 40 % shortened tip length compared with the former second generation CB advance device (CB-A). Ideally, a shorter tip should permit an improved visualisation of real-time recordings in the pulmonary vein (PV) due to a more proximal positioning of the inner lumen mapping catheter. We sought to compare the incidence of visualisation of real-time recordings in patients having undergone ablation with the CB-ST with patients having received CB-A ablation.
All patients having undergone CB ablation using CB-ST technology and the last 500 consecutive patients having undergone CB-A ablation were analysed. Exclusion criteria were the presence of an intracavitary thrombus, uncontrolled heart failure, moderate or severe valvular disease, and contraindications to general anaesthesia.
A total of 600 consecutive patients (58.1 ± 12.9 years, 64 % males) were evaluated (100 CB-ST and 500 CB-A ablations). Real-time recordings were significantly more prevalent in the CB-ST population compared with CB-A group (85.7 vs 67.2 %, p < 0.0001). Real-time recordings could be more frequently visualised in the CB-ST group in all types of veins (LSPV 89 vs 73.4 %, p = 0.0005; LIPV 84 vs 65.6 %, p = 0.0002; RSPV 87 vs 67.4 %, p < 0.0001; RIPV 83 vs 62.4 %, p < 0.0001).
The rate of visualisation of real-time recordings is significantly higher during third-generation CB-ST ablation if compared to the second-generation CB-A device. Real-time recordings can be visualised in approximately 85.7 % of veins with this novel cryoballoon.
第三代冷冻球囊Advance Short-tip（CB-ST）的设计使其尖端长度比前一代第二代CB advance设备（CB-A）缩短了40%。理想情况下，较短的尖端应能改善肺静脉（PV）实时记录的可视化效果，因为内腔标测导管的位置更靠近近端。我们试图比较接受CB-ST消融的患者与接受CB-A消融的患者中实时记录可视化的发生率。
分析了所有使用CB-ST技术进行CB消融的患者以及最近连续500例接受CB-A消融的患者。排除标准包括存在心腔内血栓、未控制的心力衰竭、中度或重度瓣膜疾病以及全身麻醉的禁忌症。
共评估了600例连续患者（年龄58.1±12.9岁，64%为男性）（100例CB-ST消融和500例CB-A消融）。与CB-A组相比，实时记录在CB-ST人群中更为普遍（85.7%对67.2%，p<0.0001）。在CB-ST组的所有类型静脉中，实时记录更频繁地被可视化（左上肺静脉89%对73.4%，p=0.0005；左下肺静脉84%对65.6%，p=0.0002；右上肺静脉87%对67.4%，p<0.0001；右下肺静脉83%对62.4%，p<0.0001）。
与第二代CB-A设备相比，第三代CB-ST消融期间实时记录的可视化率显著更高。使用这种新型冷冻球囊，约85.7%的静脉可实现实时记录的可视化。
