Current Status of Atrial Fibrillation Ablation with Balloon Strategy

Julian Kyoung-Ryul Chun; Stefano Bordignon; Shaojie Chen; Shota Tohoku; Fabrizio Bologna; Lukas Urbanek; Boris Heinrich Schmidt

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자료유형: 학술저널

저자정보: Julian Kyoung-Ryul Chun (Medizinische Klinik III CCB Kardiologie Agaplesion Markus Krankenhaus) Stefano Bordignon (Medizinische Klinik III CCB Kardiologie Agaplesion Markus Krankenhaus) Shaojie Chen (Medizinische Klinik III CCB Kardiologie Agaplesion Markus Krankenhaus) Shota Tohoku (Medizinische Klinik III CCB Kardiologie Agaplesion Markus Krankenhaus) Fabrizio Bologna (Medizinische Klinik III CCB Kardiologie Agaplesion Markus Krankenhaus) Lukas Urbanek (Medizinische Klinik III CCB Kardiologie Agaplesion Markus Krankenhaus) Boris Heinrich Schmidt (Medizinische Klinik III CCB Kardiologie Agaplesion Markus Krankenhaus)

저널정보: 대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.49 No.11

발행연도: 2019.1

수록면: 991 - 1,001 (11page)

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Catheter ablation of atrial fibrillation (AF) has been established worldwide and is recommended for symptomatic paroxysmal AF patients according to international guidelines. Importantly, the cornerstone of any AF ablation represents pulmonary vein isolation (PVI). Traditional radiofrequency (RF) point by point ablation within a 3D electroanatomic left atrial (LA) map requires profound understanding of LA anatomy and electrophysiology. This ablation strategy can be highly efficient and safe if performed in experienced hands and centers. However, procedural complexity causes a long learning curve and has limited its wide spread utilization. In contrast, balloon based PVI ablation strategies are based on an anatomic principle. Currently, two balloon types (cryoballoon and laserballoon) have been adopted to clinical routine. Both balloons are positioned at the target PV and circumferential energy ablation is enabled. This simplified anatomic approach facilitates reaching the procedural endpoint of PVI and demonstrated less operator dependency. Therefore, balloon PVI appears to be associated with improved procedural reproducibility and safety. Importantly, large scale randomized trials proved non-inferiority of balloon guided AF ablation (cryothermal and laser energy) vs. experienced operators using traditional “gold standard” RF ablation in paroxysmal and persistent AF. Ongoing technological refinements of both balloons as well as the introduction of novel energy dosing strategies and ablation targets may potentially impact the current way of ablating AF in future. This review will summarize current clinical experience of contemporary balloon devices and will look into future developments.

#Atrial fibrillation #Ablation balloon technology

참고문헌 (53)

참고문헌 신청

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