Author + information
- Received May 11, 2015
- Revision received June 1, 2015
- Accepted June 4, 2015
- Published online October 1, 2015.
- Hariharan Raju, MBChB, PhD∗ (, )
- John Gomes, MB BS,
- Hanney Gonna, MBBS, BSc and
- Mark M. Gallagher, BSc, MD
- ↵∗Reprint requests and correspondence:
Dr. Hariharan Raju, Cardiology Department, Ben Weir Ward Office, St. George’s Hospital, London SW17 0QT, United Kingdom.
- atrial fibrillation
- atrial fibrillation ablation
- pulmonary vein isolation
- pulmonary vein stump
Residual pulmonary vein stumps following pneumonectomy remain electrically active as potential triggers for atrial fibrillation. Efficacious radiofrequency pulmonary vein isolation has recently been reported in a series of 15 cases (1), though none with cryoablation to our knowledge. We present here an image illustrating the feasibility of Arctic Front Advance cryoballoon (Medtronic, Minneapolis, Minnesota) ablation following video-assisted thoracoscopic right upper lobectomy for adenocarcinoma.
The patient was a 60-year-old man with symptomatic paroxysmal atrial fibrillation. Echocardiography was unremarkable apart from mild left atrial dilation at 45 mm. Contrast venography of all 4 pulmonary veins (PV), including the right superior PV stump (Figure 1A), was performed through a FlexCath sheath (Medtronic) and 7-F National Institutes of Health (Bethesda, Maryland) catheter. Less than -45°C temperature was achieved for 2 freezes of 240 s in the right superior PV (Figure 1B) with a 28-mm cryoballoon; PV potential mapping with Achieve catheter (Medtronic) confirmed isolation (Figure 1). The 3 intact PVs were similarly isolated. The patient remained symptom-free for a 3-month follow-up period, with no sustained arrhythmia on 24-h ambulatory monitor.
Dr. Gonna has received unrestricted research funding from Biosense Webster and Boston Scientific. Dr. Gallagher has received research funding from and has consulted for Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 11, 2015.
- Revision received June 1, 2015.
- Accepted June 4, 2015.
- American College of Cardiology Foundation