Effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation: A prospective randomized study
Background: It was previously reported, based on a retrospective study, that preliminary removal of air bubbles in heparinized saline water with extracorporeal balloon inflation reduced the incidence of asymptomatic cerebral embolism (ACE). The present study aims to compare the incidence of ACE betw...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906722000690 |
| _version_ | 1811231726794440704 |
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| author | Masaaki Yokoyama Michifumi Tokuda Kenichi Tokutake Hidenori Sato Hirotsuna Oseto Kenichi Yokoyama Mika Kato Ryohsuke Narui Shin-ichi Tanigawa Seigo Yamashita Michihiro Yoshimura Teiichi Yamane |
| author_facet | Masaaki Yokoyama Michifumi Tokuda Kenichi Tokutake Hidenori Sato Hirotsuna Oseto Kenichi Yokoyama Mika Kato Ryohsuke Narui Shin-ichi Tanigawa Seigo Yamashita Michihiro Yoshimura Teiichi Yamane |
| author_sort | Masaaki Yokoyama |
| collection | DOAJ |
| description | Background: It was previously reported, based on a retrospective study, that preliminary removal of air bubbles in heparinized saline water with extracorporeal balloon inflation reduced the incidence of asymptomatic cerebral embolism (ACE). The present study aims to compare the incidence of ACE between a conventional and pre-inflation method during cryoballoon ablation in a prospective randomized controlled study. Methods: A total of 98 atrial fibrillation patients were enrolled and randomized into conventional and pre-inflation groups. Patients in the pre-inflation group received balloon massaging with preliminary extracorporeal balloon inflation in saline water before the cryoballoon was inserted into the body. Results: The baseline characteristics were similar between the two groups. Post-procedural 3-Tesla MRI revealed CE in 27.6% of patients. Symptomatic CE only occurred in two patients in the pre-inflation group. One patient had transient dysarthria and mild muscle weakness in one hand; the other patient complained of transient left upper limb weakness, left lower limb paresthesia and dysarthria. The incidence of ACE detected by cerebral MRI did not differ between the two groups to a statistically significant extent (conventional vs. pre-inflation; 22.9% vs. 29.2%; P = 0.49). In the multivariable analysis, eGFR was independently associated with the presence of ACE (odds ratio 0.95; 95% confidence interval 0.907–0.995; P = 0.03). Conclusion: In this prospective randomized study, the preliminary removal of air bubbles in heparinized saline water with extracorporeal balloon inflation had no impact on the incidence of ACE. |
| first_indexed | 2024-04-12T10:49:55Z |
| format | Article |
| id | doaj.art-561bf85954474793897aee6cfe0a8543 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-12T10:49:55Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-561bf85954474793897aee6cfe0a85432022-12-22T03:36:16ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672022-06-0140101020Effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation: A prospective randomized studyMasaaki Yokoyama0Michifumi Tokuda1Kenichi Tokutake2Hidenori Sato3Hirotsuna Oseto4Kenichi Yokoyama5Mika Kato6Ryohsuke Narui7Shin-ichi Tanigawa8Seigo Yamashita9Michihiro Yoshimura10Teiichi Yamane11Department of Cardiology, The Jikei University School of Medicine, JapanCorresponding author at: Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.; Department of Cardiology, The Jikei University School of Medicine, JapanDepartment of Cardiology, The Jikei University School of Medicine, JapanDepartment of Cardiology, The Jikei University School of Medicine, JapanDepartment of Cardiology, The Jikei University School of Medicine, JapanDepartment of Cardiology, The Jikei University School of Medicine, JapanDepartment of Cardiology, The Jikei University School of Medicine, JapanDepartment of Cardiology, The Jikei University School of Medicine, JapanDepartment of Cardiology, The Jikei University School of Medicine, JapanDepartment of Cardiology, The Jikei University School of Medicine, JapanDepartment of Cardiology, The Jikei University School of Medicine, JapanDepartment of Cardiology, The Jikei University School of Medicine, JapanBackground: It was previously reported, based on a retrospective study, that preliminary removal of air bubbles in heparinized saline water with extracorporeal balloon inflation reduced the incidence of asymptomatic cerebral embolism (ACE). The present study aims to compare the incidence of ACE between a conventional and pre-inflation method during cryoballoon ablation in a prospective randomized controlled study. Methods: A total of 98 atrial fibrillation patients were enrolled and randomized into conventional and pre-inflation groups. Patients in the pre-inflation group received balloon massaging with preliminary extracorporeal balloon inflation in saline water before the cryoballoon was inserted into the body. Results: The baseline characteristics were similar between the two groups. Post-procedural 3-Tesla MRI revealed CE in 27.6% of patients. Symptomatic CE only occurred in two patients in the pre-inflation group. One patient had transient dysarthria and mild muscle weakness in one hand; the other patient complained of transient left upper limb weakness, left lower limb paresthesia and dysarthria. The incidence of ACE detected by cerebral MRI did not differ between the two groups to a statistically significant extent (conventional vs. pre-inflation; 22.9% vs. 29.2%; P = 0.49). In the multivariable analysis, eGFR was independently associated with the presence of ACE (odds ratio 0.95; 95% confidence interval 0.907–0.995; P = 0.03). Conclusion: In this prospective randomized study, the preliminary removal of air bubbles in heparinized saline water with extracorporeal balloon inflation had no impact on the incidence of ACE.http://www.sciencedirect.com/science/article/pii/S2352906722000690Atrial fibrillationAblationCryoballoonPulmonary vein isolationCerebral embolismComplication |
| spellingShingle | Masaaki Yokoyama Michifumi Tokuda Kenichi Tokutake Hidenori Sato Hirotsuna Oseto Kenichi Yokoyama Mika Kato Ryohsuke Narui Shin-ichi Tanigawa Seigo Yamashita Michihiro Yoshimura Teiichi Yamane Effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation: A prospective randomized study International Journal of Cardiology: Heart & Vasculature Atrial fibrillation Ablation Cryoballoon Pulmonary vein isolation Cerebral embolism Complication |
| title | Effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation: A prospective randomized study |
| title_full | Effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation: A prospective randomized study |
| title_fullStr | Effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation: A prospective randomized study |
| title_full_unstemmed | Effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation: A prospective randomized study |
| title_short | Effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation: A prospective randomized study |
| title_sort | effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation a prospective randomized study |
| topic | Atrial fibrillation Ablation Cryoballoon Pulmonary vein isolation Cerebral embolism Complication |
| url | http://www.sciencedirect.com/science/article/pii/S2352906722000690 |
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