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Performance of Two Tools for Pulmonary Vein Occlusion Assessment with a Novel Navigation System in Cryoballoon Ablation Procedure
  • +6
  • Guodong Niu,
  • Yu Qiao,
  • Zhen Zhao,
  • Mingpeng Fu,
  • Xiang Cai,
  • Yulong Guo,
  • Ke Liu,
  • Jinrui Guo,
  • Tao Guo
Guodong Niu
State Key Laboratory of Cardiovascular Disease Cardiac Arrhythmia Center Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 People’s Republic of China

Corresponding Author:guodniu@126.com

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Yu Qiao
Fuwai Yunnan Cardiovascular Hospital Department of Cardiac Arrhythmia Kunming Medical University Kunming Yunnan 650032 People’s Republic of China
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Zhen Zhao
Fuwai Yunnan Cardiovascular Hospital Department of Cardiac Arrhythmia Kunming Medical University Kunming Yunnan 650032 People’s Republic of China
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Mingpeng Fu
Fuwai Yunnan Cardiovascular Hospital Department of Cardiac Arrhythmia Kunming Medical University Kunming Yunnan 650032 People’s Republic of China
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Xiang Cai
Fuwai Yunnan Cardiovascular Hospital Department of Cardiac Arrhythmia Kunming Medical University Kunming Yunnan 650032 People’s Republic of China
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Yulong Guo
Fuwai Yunnan Cardiovascular Hospital Department of Cardiac Arrhythmia Kunming Medical University Kunming Yunnan 650032 People’s Republic of China
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Ke Liu
Fuwai Yunnan Cardiovascular Hospital Department of Cardiac Arrhythmia Kunming Medical University Kunming Yunnan 650032 People’s Republic of China
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Jinrui Guo
Fuwai Yunnan Cardiovascular Hospital Department of Cardiac Arrhythmia Kunming Medical University Kunming Yunnan 650032 People’s Republic of China
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Tao Guo
Fuwai Yunnan Cardiovascular Hospital Department of Cardiac Arrhythmia Kunming Medical University Kunming Yunnan 650032 People’s Republic of China
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Abstract

Background Optimal occlusion of pulmonary vein (PV) is essential for atrial fibrillation (AF) cryoballoon ablation (CBA). The aim of the study was to investigate the performance of two different tools for the assessment of PV occlusion with a novel navigation system in CBA procedure. Methods In consecutive patients with paroxysmal AF who underwent CBA procedure with the guidance of the novel 3-dimentional mapping system, the baseline tool, injection tool and pulmonary venography were all employed to assess the degree of PV occlusion, and the corresponding cryoablation parameters were recorded. Results In 23 patients (mean age 60.0 + 13.9 years, 56.5% male), a total of 149 attempts of occlusion and 122 cryoablations in 92 PVs were performed. Using pulmonary venography as the gold standard, the overall sensitivity, specificity of the baseline tool was 96.7% (95% CI 90.0% - 99.1%), and 40.5% (95% CI 26.0% - 56.7%), respectively, while the corresponding value of the injection tool was 69.6% (95% CI 59.7% - 78.1%), and 100.0% (95% CI 90.6% - 100.0%), respectively. Cryoablation with optimal occlusion showed lower nadir temperature (baseline tool: -44.3 + 8.4 ℃ vs -35.1 + 6.5 ℃, p < 0.001; injection tool: -46.7 + 6.4 ℃ vs -38.3 + 9.2 ℃, p < 0.001) and longer total thaw time (baseline tool: 53.3 + 17.0 s vs 38.2 + 14.9 s, p = 0.003; injection tool: 58.5 + 15.5 s vs 41.7 + 15.2 s, p < 0.001) compared with those without. Conclusions Both tools were able to accurately assess the degree of PV occlusion and predict the acute cryoablation effect, with the baseline tool being more sensitive and the injection tool more specific.
05 Sep 2022Submitted to Journal of Cardiovascular Electrophysiology
06 Sep 2022Submission Checks Completed
06 Sep 2022Assigned to Editor
08 Sep 2022Reviewer(s) Assigned
01 Nov 2022Review(s) Completed, Editorial Evaluation Pending
02 Nov 2022Editorial Decision: Revise Minor
06 Nov 20221st Revision Received
09 Nov 2022Submission Checks Completed
09 Nov 2022Assigned to Editor
09 Nov 2022Review(s) Completed, Editorial Evaluation Pending
09 Nov 2022Reviewer(s) Assigned
14 Nov 2022Editorial Decision: Accept