Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-179 - Left Atrial Roof Cryo Balloon Ablation Does Not Impair The Electrical Conduction From Right Atrium To Left Atrial Appendage And Preserves Left Atrial And Ventricular Function (ID 242)


Background: Left atrial (LA) roof linear ablation using a second-generation cryoballoon (CB) is currently performed for the treatment of paroxysmal and persistent atrial fibrillation (AF). However, the effects of LA roof ablation with the CB on the intra- and inter- atrial conduction has not yet been investigated well.
Objective: The aim of the present study is to evaluate the effects of LA roof ablation with CB on the intra-and inter- atrial conduction using electrical mapping catheters at ablation.
Methods: We enrolled 15 consecutive patients with paroxysmal AF who underwent CB ablation with the aim of pulmonary vein isolation (PVI) and bidirectional conduction block across the LA roof. Twenty-polar atrial cardioversion (BeeAT) catheter was placed in the coronary sinus (CS) to detect the bipolar electrical activities of CS, right atrial (RA) and superior vena cava (SVC). Twenty-polar electrode ring catheter was also inserted in the orifice of LAA. Before and after the ablation, the time difference between the earliest onset of the electrical activations of RA among the BeeAT catheter and the onset of the activation of LAA (TRA-LAA) was measured during sinus rhythm. Echocardiographical analysis was also performed before and after the ablation, and LA and left ventricular (LV) functions were evaluated by measuring the peak velocities of early (E) and late (A) mitral inflow, the deceleration time of the E wave (DcT), and early diastolic mitral annulus velocity (e') estimated by tissue Doppler.
Results: PVI plus LA roof ablation were achieved and bidirectional conduction block across the LA roof was verified in all patients. Averaged TRA-LAA was not changed by the PVI plus LA roof ablation compared to the values obtained at pre-ablation (73.1±5.3 ms vs. 72.6±23.1 ms, P=0.89). There was no significant difference between the echo data before and after the ablations in LA dimension (37.5±5.9 vs. 38.1±5.3 mm), LV ejection fraction (65.1±8.0 vs. 67.5±3.9%), DcT (178±51 vs. 166±45 ms), E/A (1.21±0.53 vs. 1.49±0.48), E/e’ (8.1±2.4 vs. 9.1±3.8).
Conclusion: Left atrial roof ablation by cryoballoon does not delay the activation time from RA to LAA, and preserves the atrial and ventricular function. Electrical isolation of left atrial roof can be safely achieved by cryoballoon ablation.