Failure to reach the optimal temperature during cryoablation due to refrigerant cylinder problem

Narendra Kumar, Trang Dinh, Mohamed Magdi Abbas, Kevin Phan, Randolph Manusama, Suzanne Philippens, Jos Maessen, Carl Timmermans

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Abstract

INTRODUCTION: Pulmonary vein (PV) isolation is considered as a key to atrial fibrillation (AF) treatment. Cryoballoon ablation is an effective therapy for PV isolation for AF with minimal side effects and was approved by the US Food and Drug Administration (FDA) several years ago. Successful isolation of PVs during cryoablation depends on the balloon temperature and helps in early identification of noneffective cryoballoon applications. A lower balloon temperature has been associated with long-term success in isolation of PVs.

CASE PRESENTATION: At the start of the procedure, the cryoconsole displayed "low refrigerant level". After a few cycles of successful cryoballoon applications, for a fresh application for a new PV, the optimal temperature was not obtained in spite of obtaining good grade of occlusion and ostial positioning for right inferior pulmonary vein (RIPV). Later, immediately after changing the refrigerant cylinder, suitable temperature was obtained. We faced this situation thrice in a span of eight months.

CONCLUSION: Low refrigerant level may cause nonoptimal temperature during cryoablation, which can be resolved by premature change of a gas cylinder.

Original languageEnglish
Article numbere25592
Pages (from-to)1-3
Number of pages3
JournalResearch in cardiovascular medicine
Volume4
Issue number1
DOIs
Publication statusPublished - Feb 2015
Externally publishedYes

Bibliographical note

Copyright the Publisher 2015. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • atrial fibrillation
  • cryoablation
  • pulmonary vein
  • refrigeration

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