期刊
HEART RHYTHM
卷 18, 期 8, 页码 1435-1444出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2021.04.020
关键词
Atrial fibrillation; Catheter ablation; Cryoablation; Cryoballoon; Intracardiac echocardiography; Mapping; Posterior wall; Pulmonary vein isolation; Roof
Segmental, nonocclusive cryoballoon ablation, targeting not only large/common pulmonary vein structures but also extra-PV areas such as the left atrial roof and posterior wall, has shown improved clinical efficacy in patients with persistent atrial fibrillation. This approach utilizes enhanced stability and durability of cryolesions to effectively treat AF, making it a promising strategy for comprehensive ablation.
Although cryoballoon ablation of atrial fibrillation (AF) traditionally has been guided by pulmonary vein (PV) occlusion, there is evidence and growing interest in performing segmental, nonocclusive cryoballoon ablation to target not only large/common PVs but extra-PV structures such as the left atrial (LA) roof and posterior wall in conjunction with PV isolation. A number of studies have demonstrated improved clinical efficacy associated with nonocclusive cryoballoon ablation of the LA roof and posterior wall in addition to PV isolation, particularly in patients with persistent AF. Not only can the cryoballoon be used for targeting extra-PV structures through segmental, nonocclusive ablation, but the large size and durability of cryolesions coupled with the enhanced stability afforded through cryoadhesion render the cryoballoon an effective tool for such an approach. This article reviews the rationale and practical approach to segmental, nonocclusive cryoballoon ablation of large/common PV antra and the LA roof and posterior wall.
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