First confirmation of histologic changes in the human heart after cryoballoon ablation Tatsuhiko Hirao, MD, Junichi Nitta, MD, PhD, Akiko Adachi, MD,

Slides:

Advertisements

Similar presentations

Volume 13, Issue 1, Pages (January 2016)

Advertisements

Functional permanent 2:1 atrioventricular block treated with cardioneuroablation: Case report Tolga Aksu, MD, Sukriye Ebru Golcuk, MD, Tümer Erdem Guler,

Isolation of an arrhythmogenic roof vein with the guide of a circular mapping catheter in a case with paroxysmal atrial fibrillation Shin-ichi Tanigawa,

Successful use of bivalirudin in place of heparin infusion for pulmonary vein isolation using a cryoballoon catheter in a patient with heparin allergy

Chronic Histological Transmurality of High-Intensity Focused Ultrasound Ablation Paolo Vanelli, MD, Roberta Rossi, MD, Guido Gelpi, MD, Giovanni Cagnoni,

Laurent Pison, MD, Mark La Meir, MD, Harry J. Crijns, MD, PhD

Volume 12, Issue 2, Pages (February 2015)

Pulmonary vein isolation and autonomic denervation for the management of paroxysmal atrial fibrillation by a minimally invasive surgical approach James.

Cardioneuroablation in ictal asystole—New treatment method

Killing two gaps with a single activation map—Visualization of the precise macroreentrant circuit including the pulmonary vein and left atrium Hiro Yamasaki,

A novel mapping technique to detect non–pulmonary vein triggers: A case report of self- reference mapping technique Yasuharu Matsunaga-Lee, MD, Yuzuru.

Volume 13, Issue 1, Pages (January 2016)

Intraatrial reentrant tachycardia originating from the prior suture line of the baffle in a patient who underwent the Mustard operation: Ultra-high-density.

Radiofrequency ablation of typical atrial flutter with access through the azygos vein in a patient with heterotopia utilizing high-density electroanatomic.

A pseudo-sinus rhythm due to bigeminal ectopy with the focus in the right superior pulmonary vein Marina Arai, MD, Seiji Fukamizu, MD, PhD, Rintaro Hojo,

Peri–coronary sinus atrial flutter associated with prior slow pathway ablation Mitsunori Maruyama, MD, PhD, FHRS, Shunsuke Uetake, MD, PhD, Yasushi Miyauchi,

HeartRhythm Case Reports

Induction of tachycardia confined within a pulmonary vein by electrical cardioversion of atrial fibrillation: Is it proof of reentry? Mauro Toniolo,

An interesting case of reverse electrical remodeling of the left atrium after radiofrequency ablation Bharath Yarlagadda, MD, Tawseef Dar, MD, Valay.

Common veins, common freezes

Radiofrequency catheter ablation for drug-refractory paroxysmal atrial fibrillation in a patient with Ebstein’s anomaly Yong-Giun Kim, MD, Shin-Jae Kim,

Single-shot antral isolation of a common pulmonary vein by the hot balloon Yuji Wakamatsu, MD, Koichi Nagashima, MD, PhD, Ryuta Watanabe, MD, Masaru Arai,

A new instrument of suction support adapter system for epicardial radiofrequency ablation Shinichi Kadoya, MD, Go Watanabe, MD, Yoshinao Koshida, MD,

Functional permanent 2:1 atrioventricular block treated with cardioneuroablation: Case report Tolga Aksu, MD, Sukriye Ebru Golcuk, MD, Tümer Erdem Guler,

Preferential properties with decremental conduction of the Marshall vein between the coronary sinus and left superior pulmonary vein Toshiya Kurotobi,

Correlation between functional electrical gaps identified by ultrahigh-density mapping and by late gadolinium enhancement cardiac magnetic resonance in.

Direct visualization of an atrial transseptal left ventricular endocardial lead implantation within an isolated heart Zhongping Yang, PhD, Michael D.

Fracture and retrieval of an Achieve circular mapping catheter in and from a pulmonary vein during cryoballoon ablation for atrial fibrillation Richard.

A rare variant of pulmonary vein drainage

Swallowing-induced atrial tachycardia arising from superior vena cava: Significant involvement of parasympathetic nerve activity Koji Higuchi, MD, PhD,

Intra-atrial reentrant tachycardia originating from the pulmonary vein cuff anastomosis in a lung transplantation patient: Ultra-high-density 3-dimensional.

Novel technique to avoid diaphragmatic paralysis during focal ablation of a non– pulmonary vein trigger mapped to the crista terminalis Jason Misher,

HeartRhythm Case Reports

Cavotricuspid isthmus ablation using multimodality imaging in Ebstein anomaly with a mechanical tricuspid valve replacement Sang Hyun Lee, MD, Hyung.

Termination of anticoagulation therapy at 45 days after concomitant atrial fibrillation catheter ablation and left atrial appendage occlusion resulting.

Hemoptysis after five months of cryoballoon ablation: What is the relationship? Keita Watanabe, MD, Junichi Nitta, MD, PhD, Akira Sato, MD, Masahiko Goya,

Successful transseptal puncture and cryoballoon ablation of symptomatic paroxysmal atrial fibrillation via jugular access in a patient with bilateral.

Focal atrial fibrillation presenting in the origin of atrial tachycardia Chin-Yu Lin, MD, Yenn-Jiang Lin, MD, Fa-Po Chung, MD, Shih-Ann Chen, MD HeartRhythm.

Mindy Vroomen, MD, Mark La Meir, MD, Harry J

Stephen A. Howard, PhD, Ryan P. Goff, PhD, David G

Borut Geršak, MD, PhD, Matevž Jan, MD The Annals of Thoracic Surgery

Electroanatomical high-density mapping of different tachycardias in the right atrium after heart transplantation Alexandra Schratter, MD, Valentina Schirripa,

Successful use of bivalirudin in place of heparin infusion for pulmonary vein isolation using a cryoballoon catheter in a patient with heparin allergy

Successful ablation for non-pulmonary multi-foci atrial fibrillation/tachycardia in a patient with coronary sinus ostial atresia by transseptal puncture.

A novel mapping and ablation strategy of the mitral isthmus using intracardiac echocardiography in the left atrium Thomas J. Flautt, DO, Alison L. Spangler,

Progressive modification of rotors in persistent atrial fibrillation by stepwise linear ablation Jichao Zhao, PhD, Yan Yao, MD, PhD, Rui Shi, MD, PhD,

Pericardial adhesions as a consequence of cryoballoon ablation detected during the hybrid AF ablation procedure Vedran Velagic, MD, Carlo de Asmundis,

HeartRhythm Case Reports

Endocardial-only catheter ablation with substantial improvement in ventricular fibrillation recurrences in a patient with Brugada syndrome Tatsuya Hayashi,

Cryoballoon pulmonary vein isolation and voltage mapping for symptomatic atrial fibrillation 9 months after Watchman device implantation Henry D. Huang,

Atsuyuki Watanabe, MD, Atsuko Seki, MD, Michael C

Canadian Cardiovascular Society Atrial Fibrillation Guidelines 2010: Catheter Ablation for Atrial Fibrillation/Atrial Flutter Atul Verma, MD, FRCPC,

Utility of entrainment pacing to clarify the circuit of macroreentrant tachycardia with dual early sites on activation maps Koichi Nagashima, MD, PhD,

Adam J. Small, MD, Eric F. Buch, MD, FHRS, FACC, Daniel R

Clinical and electrophysiological features of respiratory cycle–dependent atrial tachycardia: An analysis of three cases Osamu Inaba, MD, Junichi Nitta,

Simultaneous isolation of the four pulmonary veins by single-sided antral ablation Andres Enriquez, MD, Usama Boles, MD, Adrian Baranchuk, MD, Damian.

Emergency left arial appendage clipping after percutaneous pulmonary vein isolation in a patient with a partial anomalous pulmonary venous connection

The multi–purse string maze procedure: A new surgical technique to perform the full maze procedure without atriotomies Niv Ad, MD The Journal of Thoracic.

Atrial fibrillation resulting from superior vena cava drivers addressed with cryoballoon ablation: Late reconnection at the site of phrenic nerve pacing.

Pulmonary vein stenosis after second-generation cryoballoon ablation for atrial fibrillation Kenichi Tokutake, MD, Michifumi Tokuda, MD, PhD, Takayuki.

Nishaki Mehta, MD, Benjamin E. Peterson, MD, Roy M. John, MD, PhD

Atrial fibrillation ablation performed in the developing world: A description of the first atrial fibrillation ablation performed in Cambodia Sri Sundaram,

Getting to the right left atrium: Catheter ablation of atrial fibrillation and mitral annular flutter in cor triatriatum Ryan T. Borne, MD, Jaime Gonzalez,

Periesophageal vagal nerve injury following catheter ablation of atrial fibrillation: A case report and review of the literature Sandeep A. Saha, MD,

Usefulness of a 2-F catheter electrode in a case with successful electrical isolation of remarkably hypoplastic right inferior pulmonary vein Takeshi.

HeartRhythm Case Reports

Bradycardia-induced polymorphic ventricular tachycardia after radiofrequency catheter ablation for right atrial flutter Matthew Zada, BMedSc(Hons), MBBS,

Atrial flutter following ethanol infusion in the vein of Marshall

Chance M. Witt, MD, Samuel J. Asirvatham, MD, FHRS, Carole A

Ablation of Atrial Fibrillation With Minimally Invasive Mitral Surgery

Presentation transcript:

First confirmation of histologic changes in the human heart after cryoballoon ablation Tatsuhiko Hirao, MD, Junichi Nitta, MD, PhD, Akiko Adachi, MD, Yoshihide Takahashi, MD, PhD, Masahiko Goya, MD, PhD, Kenzo Hirao, MD, PhD, FHRS HeartRhythm Case Reports Volume 5, Issue 2, Pages 93-96 (February 2019) DOI: 10.1016/j.hrcr.2018.10.012 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 Voltage mapping of the left atrium and pulmonary veins after cryoballoon ablation with all pulmonary veins electrically isolated. LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein. HeartRhythm Case Reports 2019 5, 93-96DOI: (10.1016/j.hrcr.2018.10.012) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 A: Developed view of the left atrium (LA). In gross pathologic findings, the lesion after cryoballoon ablation of the LA is unclear, but after careful review, it is evident that the lesion has changed to a pale beige color. B: Macroscopic pathology of the radiofrequency lesion of the inferior vena cava (IVC)–tricuspid isthmus. Subintimal hemorrhage in the lesion is observed. LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RFCA = radiofrequency catheter ablation; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein. HeartRhythm Case Reports 2019 5, 93-96DOI: (10.1016/j.hrcr.2018.10.012) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 3 Histologic samples stained with Azan. Fibrotic tissue is blue, and muscle tissue is red. A: Medium-power field of the cryoballoon lesion in the right inferior pulmonary vein antrum. A transmural lesion that had been replaced with fibrotic tissue is observed in the vein. No thrombus formation is observed in the lesion. Inset (upper right) shows the high-power field of the yellow square area. The area is not completely replaced with fibrotic tissue like the endocardial part; however, fibrous granulation tissue formation is observed with myocardial destruction, and there is no normal formation of atrial muscle. With time, macrophages will phagocytize these tissues and induce fibrosis, but because only 6 months have passed since ablation, the process of fibrosis is not yet complete. B: Low-power field of the cryoballoon lesion of the right superior pulmonary vein (RSPV) antrum. The width of the transmural lesion is 6 mm. C: Medium-power field of the radiofrequency lesion of the inferior vena cava–tricuspid isthmus. The patchy fibrotic tissue is stained blue by Azan and not clearly demarcated from the normal myocardium. D: Medium-power field of the radiofrequency lesion of the inferior vena cava–tricuspid isthmus with Azan staining. Gray pigmentation of hemosiderin is observed in the subintimal area of the lesion. LA = left atrium. HeartRhythm Case Reports 2019 5, 93-96DOI: (10.1016/j.hrcr.2018.10.012) Copyright © 2018 Heart Rhythm Society Terms and Conditions