Nevertheless, some remarks about ablation therapy should be discussed:
- The success of AF ablation is highly dependent on the operator’s skills and his experience.
- There is no consensus protocol on how to perform the freezing period in the ablation and each laboratory takes the blanking period as they consider.
The FIRE and ICE randomized trial concluded that cryoablation was found to be noninferior to RF ablation in symptomatic patients with drug-refractory pAF either non ablation technologies was superior (24). Furthermore, some randomized controlled trials have demonstrated superior results in restoration sinus rhythm with catheter ablation compared with ADD and improving the quality of life (26).
Complications are presented in a low …show more content…
Pulmonary vein abnormalities are predictors of bad prognosis for the success of the procedure (41).
A doubled-walled cryoballoon catheter is thread through the heart and located in the ostium of the pulmonary veins. Selective contrast is injected to check if it has achieved total occlusion of the vessels as there is no backflow back into the atrium. Once it is isolated, CB catheter inflates and it is filled with coolant (NO2). That material goes from liquid to gas and freeze the tissue and destroy the triggers in 80% of success rate (44). This procedure is done for each pulmonary vein. It is a single-step mode. Cryoenery application last 180 second even though there is no definitive protocol about that and some laboratories applies it for 120 seconds with the same efficacy (42). Pulmonary vein activity is recorded with the inner lumen mapping catheter. After the freezing, if it is successful, PV potential disappears.
After the procedure, intravenous heparin is continued followed with oral anticoagulation, for at least 3 months. AADs are taken for 3 months post ablation and then they will be discontinued. All patients then, undergo to a Holter-ECG for seven-days to see the atrial fibrillation burden
- The success of AF ablation is highly dependent on the operator’s skills and his experience.
- There is no consensus protocol on how to perform the freezing period in the ablation and each laboratory takes the blanking period as they consider.
The FIRE and ICE randomized trial concluded that cryoablation was found to be noninferior to RF ablation in symptomatic patients with drug-refractory pAF either non ablation technologies was superior (24). Furthermore, some randomized controlled trials have demonstrated superior results in restoration sinus rhythm with catheter ablation compared with ADD and improving the quality of life (26).
Complications are presented in a low …show more content…
Pulmonary vein abnormalities are predictors of bad prognosis for the success of the procedure (41).
A doubled-walled cryoballoon catheter is thread through the heart and located in the ostium of the pulmonary veins. Selective contrast is injected to check if it has achieved total occlusion of the vessels as there is no backflow back into the atrium. Once it is isolated, CB catheter inflates and it is filled with coolant (NO2). That material goes from liquid to gas and freeze the tissue and destroy the triggers in 80% of success rate (44). This procedure is done for each pulmonary vein. It is a single-step mode. Cryoenery application last 180 second even though there is no definitive protocol about that and some laboratories applies it for 120 seconds with the same efficacy (42). Pulmonary vein activity is recorded with the inner lumen mapping catheter. After the freezing, if it is successful, PV potential disappears.
After the procedure, intravenous heparin is continued followed with oral anticoagulation, for at least 3 months. AADs are taken for 3 months post ablation and then they will be discontinued. All patients then, undergo to a Holter-ECG for seven-days to see the atrial fibrillation burden