PMID- 29885677
OWN - NLM
STAT- MEDLINE
DCOM- 20190114
LR  - 20190114
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 265
DP  - 2018 Aug 15
TI  - Atrioventricular conduction disturbance during pulmonary vein isolation using the
      second-generation cryoballoon - Vagal impact of cryoballoon ablation.
PG  - 113-117
LID - S0167-5273(18)31086-6 [pii]
LID - 10.1016/j.ijcard.2018.03.134 [doi]
AB  - BACKGROUND: Vagal reactions of the sinus node during pulmonary vein isolation
      (PVI) have been reported, however, data on intra-procedural atrioventricular
      conduction disturbances have been sparse. The present study aimed to investigate 
      the clinical characteristics of atrioventricular conduction block (AVB) during
      PVI using second-generation cryoballoons. METHODS: A total of 2252 PVs among 568 
      consecutive atrial fibrillation patients undergoing PVI with 28-mm cryoballoons
      were analyzed. In 44 patients, left superior PVs (LSPVs) were initially targeted 
      (initial-LSPV-group). In the remaining 524 patients, LSPVs were targeted
      following right superior PVs (RSPVs) (initial-RSPV-group). RESULTS: Marked sinus 
      arrests/bradycardia occurred in 14 patients only in the initial-LSPV-group, and
      the incidence was significantly higher in the initial-LSPV than
      initial-RSPV-group (14/44 vs. 0/524, p<0.001). Intra-procedural AVB with 3.6
      [1.9-8.2] second maximal RR intervals appeared in 12 patients during freezing
      (n=1) or after balloon deflation following freezing (n=11). The targeted PVs were
      the LSPV, left common PV, right inferior PV, and RSPV in 8, 1, 2, and 1 patients,
      respectively. The incidence was similar between the initial-LSPV and
      initial-RSPV-groups (1/44 vs. 11/524, p=0.938). Four patients exhibited complete 
      AVB with more than a 6s maximal RR interval. Three patients experienced AVB
      during atrial fibrillation. AVB was observed a median of 23.0 [15.0-70.0] seconds
      after balloon deflation and 76.0 [60.0-125.0] seconds after freezing termination.
      AVB persisted for 56.0 [36.0-110.0] seconds, and all recovered spontaneously with
      or without requiring back-up pacing. CONCLUSIONS: A marked transient AV
      conduction disturbance could occur after balloon deflation, especially during
      LSPV ablation, regardless of the order of targeted PVs.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Miyazaki, Shinsuke
AU  - Miyazaki S
AD  - Department of Cardiovascular medicine, Fukui University, Fukui, Japan. Electronic
      address: mshinsuke@k3.dion.ne.jp.
FAU - Kajiyama, Takatsugu
AU  - Kajiyama T
AD  - Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan.
FAU - Watanabe, Tomonori
AU  - Watanabe T
AD  - Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan.
FAU - Hada, Masahiro
AU  - Hada M
AD  - Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan.
FAU - Yamao, Kazuya
AU  - Yamao K
AD  - Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan.
FAU - Nakamura, Hiroaki
AU  - Nakamura H
AD  - Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan.
FAU - Hachiya, Hitoshi
AU  - Hachiya H
AD  - Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan.
FAU - Tada, Hiroshi
AU  - Tada H
AD  - Department of Cardiovascular medicine, Fukui University, Fukui, Japan.
FAU - Hirao, Kenzo
AU  - Hirao K
AD  - Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan.
FAU - Iesaka, Yoshito
AU  - Iesaka Y
AD  - Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
CIN - Int J Cardiol. 2018 Aug 15;265:132-133. PMID: 29885679
MH  - Aged
MH  - Atrioventricular Block/*diagnostic imaging/etiology/physiopathology
MH  - Catheter Ablation/*adverse effects/instrumentation
MH  - Cryosurgery/*adverse effects/instrumentation
MH  - Female
MH  - Humans
MH  - Intraoperative Complications/*diagnostic imaging/etiology/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Veins/*surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - *Atrial fibrillation
OT  - *Atrioventricular conduction block
OT  - *Cryoballoon
OT  - *Pulmonary vein isolation
OT  - *Vagal reaction
EDAT- 2018/06/11 06:00
MHDA- 2019/01/15 06:00
CRDT- 2018/06/11 06:00
PHST- 2018/02/16 00:00 [received]
PHST- 2018/03/21 00:00 [revised]
PHST- 2018/03/27 00:00 [accepted]
PHST- 2018/06/11 06:00 [entrez]
PHST- 2018/06/11 06:00 [pubmed]
PHST- 2019/01/15 06:00 [medline]
AID - S0167-5273(18)31086-6 [pii]
AID - 10.1016/j.ijcard.2018.03.134 [doi]
PST - ppublish
SO  - Int J Cardiol. 2018 Aug 15;265:113-117. doi: 10.1016/j.ijcard.2018.03.134.