PO-711-04 CONTRASTLESS VERIFICATION OF PULMONARY VEIN OCCLUSION WITH A DEDICATED SOFTWARE IN ATRIAL FIBRILLATION CRYOBALOON ABLATION

Abstract

In atrial fibrillation (AF) cryobaloon ablation, optimal pulmonary vein (PV) occlusion is mandatory to obtain effective and long-lasting pulmonary vein isolation (PVI). The purpose of this study was to assess the success rate of cryobaloon PVI in AF patients by verifying circumferential PV occlusion with a dielectric sensing occlusion tool. 21 consecutive patients undergoing cryobaloon ablation for paroxysmal AF at our centre were included in the analysis. The electroanatomical map of the left atrium was reconstructed with an octapolar mapping catheter (Achieve Advance 20 mm catheter, Medtronic Inc.), using the KODEX-EPD system. Proper circumferential occlusion of the PV antra with the inflated cryobaloon (Arctic Front Advance) was verified with the dedicated dielectric sensing occlusion tool, without using iodinated dye injections. The primary outcome was AF recurrence, and was assessed with periodical Holter monitors at 3-month intervals or continuous rhythm monitoring, when available. Intra- or peri-procedural complications were secondary outcomes. Of the 21 patients enrolled, n=17 were female (81%), the mean age was 59±11 years, and the mean volume of the left atrium was 31±11 ml/m2. To obtain PVI, 125 cryobaloon applications were required (6 per patient). Five patients (24%) received an implantable loop recorder for continuous rhythm monitoring. After a median follow-up of 5 months (interquartile range, 2-7), 20 patients (95%) were free from recurrent AF episodes. There were no intra- or peri-procedural complications, and no iodinated dye injections were required to verify PV occlusion. Our study confirms that a dedicated dielectric sensing occlusion tool may avoid the need to perform PV venography during cryobaloon ablation, with optimal survival free from recurrences at short-term follow-up.