reduction-iatrogenic-atrial-septal-defects-with-an-anterior-inferior

Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter

The cryoballoon catheter ablates atrial fibrillation (AF) triggers in the left atrium (LA) and pulmonary veins (PVs) via transseptal access. The typical ...

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Cardiac-targeted expression of truncated K(v)4.2 subunit (K(v)4.2N) reduces transient outward current (I(to)) density, prolongs action potentials (APs), and enhances contractility in 3- to 4-week-old transgenic mice. By 13 to 15 weeks of age, these mice develop severely impaired cardiac function and signs of heart failure. In this study, we examined whether augmented contractility in K(v)4.2N mice results from elevations in intracellular calcium ([Ca2+]i) secondary to AP prolongation and investigated the putative roles of calcineurin activation in heart disease development of K(v)4.2N mice.

Inhibition of calcineurin and sarcolemmal Ca2+ influx protects cardiac morphology and ventricular function in K(v)4.2N transgenic mice.

Researchers have used the rat model of myocardial infarction for more than 20 y to successfully mimic the detrimental effects of coronary occlusion of the left anterior descending (LAD) coronary artery in humans. But researchers have published little about this surgery's intricacies or about the pathological progression of the disease after surgery. The authors describe a refined technique that uses a suture anchor at the apex of the heart, which allows easy and accurate placement of a ligature around the LAD. Furthermore, they detail the pathological timeline for the deposition of collagen in the injured left ventricle, a hallmark of myocardial infarction. Researchers can use this refined technique to easily create a rat myocardial infarction and use the pathophysiological markers described herein to follow disease progression.

Using a cardiac anchor to refine myocardial infarction surgery in the rat.

To date, there is 1 case report publication of AE fistula during the employment of the first-generation cryoballoon (Gen-1). Recently the Arctic Front Advance system (second-generation cryoballoon) was introduced into the US and EU markets. For the purpose of peer education, we report a case of AE fistula that occurred during the utilization of the second-generation cryoballoon (Gen-2). Additionally, we review current best practices that may reduce the risk of AE fistula during any AF ablation procedure.

Atrioesophageal fistula during cryoballoon ablation for atrial fibrillation.

Point-to-point focal radiofrequency (RF) catheter ablation for aberrant pulmonary vein triggers that manifest into atrial fibrillation (AF) is the traditional method for treating symptomatic drug-resistant paroxysmal AF (PAF) when an ablation procedure is warranted. More recently, pulmonary vein isolation (PVI) using the cryoballoon has been demonstrated to be safe and effective (STOP AF clinical trial). Currently, two small studies have reviewed the procedural efficiency when comparing cryoballoon to focal RF catheter ablation procedures; however, no multicenter study has yet reported on this comparison of the two types of ablation catheters.

Comparison of resource utilization of pulmonary vein isolation: cryoablation versus RF ablation with three-dimensional mapping in the Value PVI Study.

There is limited data available on the safety and efficacy of the second-generation cryoballoon (CB-2) for cryoablation of atrial fibrillation (Cryo-AF). We evaluated the procedural, biophysical, and clinical outcomes of Cryo-AF in a large patient cohort using CB-2 as compared with the first-generation cryoballoon (CB-1).

Acute procedural and cryoballoon characteristics from cryoablation of atrial fibrillation using the first- and second-generation cryoballoon: a retrospective comparative study with follow-up outcomes.

There are 2 Food and Drug Administration-approved catheters (ThermoCool RF and Arctic Front Advance cryoballoon) for the treatment of drug refractory and symptomatic paroxysmal atrial fibrillation. Each tool is used to ablate the area surrounding the pulmonary veins (PVs). However, no study has described and quantified the ablated surface area after the application of cryoablation lesions with the second-generation cryoballoon.

Quantification of the cryoablation zone demarcated by pre- and postprocedural electroanatomic mapping in patients with atrial fibrillation using the 28-mm second-generation cryoballoon.

Low levels of HDL-C are an independent cardiovascular risk factor associated with increased premature cardiovascular death. However, HDL-C therapies historically have been limited by issues relating to immunogenicity, hepatotoxicity and scalability, and have been ineffective in clinical trials.

Article	Year
Inhibition of calcineurin and sarcolemmal Ca2+ influx protects cardiac morphology and ventricular function in K(v)4.2N transgenic mice. Circulation\| PubMed ID: 11956130	2002
Using a cardiac anchor to refine myocardial infarction surgery in the rat. Lab animal\| PubMed ID: 20859279	2010
Atrioesophageal fistula during cryoballoon ablation for atrial fibrillation. Journal of cardiovascular electrophysiology\| PubMed ID: 24172231	2014
Comparison of resource utilization of pulmonary vein isolation: cryoablation versus RF ablation with three-dimensional mapping in the Value PVI Study. The Journal of invasive cardiology\| PubMed ID: 24907083	2014
Acute procedural and cryoballoon characteristics from cryoablation of atrial fibrillation using the first- and second-generation cryoballoon: a retrospective comparative study with follow-up... Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing\| PubMed ID: 25227868	2014
Quantification of the cryoablation zone demarcated by pre- and postprocedural electroanatomic mapping in patients with atrial fibrillation using the 28-mm second-generation cryoballoon. Heart rhythm : the official journal of the Heart Rhythm Society\| PubMed ID: 25460865	2015
Therapeutic ultrasound: Increased HDL-Cholesterol following infusions of acoustic microspheres and apolipoprotein A-I plasmids. Atherosclerosis\| PubMed ID: 25969892	2015

Hae W. Lim

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