Hands On
How to perform antral pulmonary venous isolation using the cryoballoon
This article describes our current practice, clinical outcomes, and future directions for the use of balloon cryoablation for the treatment of atrial fibrillation.Novel ablative approach for atrial fibrillation to decrease risk of esophageal injury
Percutaneous atrial fibrillation (AF) ablation using catheter-delivered radiofrequency energy continues to improve in safety and effectiveness. Nonetheless, the potential risk of esophageal injury often limits the ability to fully ablate the posterior portion of the left atrium to achieve optimal procedural success without complications. We present a comprehensive approach that addresses this challenge. Our ablative strategies include (1) identifying the esophagus to minimize ablative energy, when possible, in the proximity of the esophagus, (2) maximize the ability of the esophagus to remove heat and to heal from potential thermal injury, and (3) optimizing energy delivery to avoid deep tissue injury while maintaining procedural efficacy.Pulmonary vein–related maneuvers: Part I
With the rapid evolution of atrial fibrillation ablation procedures, electrophysiologists have necessarily strived for simple and anatomic-based approaches. In all except the most straightforward procedures, however, questions regarding the significance of various potentials recorded on mapping and ablation catheters arise.1,2 Other articles in this series have described in detail the various approaches to atrial fibrillation ablation. In this article, the anatomic and electrophysiologic bases for pacing maneuvers used with a variety of ablation approaches are reviewed.
