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The sheath-in-sheath technique, utilizing a 15Fr cryoballoon delivery sheath inserted into a 25 cm 16Fr sheath, effectively navigates tortuous iliac veins during cryoballoon ablation for atrial fibrillation, ensuring safe delivery and maintaining essential device performance without complications.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297528 | PMC |
http://dx.doi.org/10.1002/ccr3.9257 | DOI Listing |
Heart Rhythm O2
August 2025
Division of Cardiology, Tokyo Metropolitan Ohkubo Hospital, Shinjyuku-ku, Tokyo, Japan.
Background: Various methods have been devised for catheter ablation of persistent atrial fibrillation (AF). However, it remains difficult to understand the mechanism of AF and to determine the optimal method.
Objective: This study aimed to evaluate the effectiveness of rotor modification (RM) compared to posterior wall isolation (PWI) in the treatment of persistent AF.
Heart Rhythm O2
August 2025
Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Background: A new technology, the POLAR cryoballoon system, was designed to enhance maneuvering and stabilizing catheter positions with a softer balloon and more deflectable sheath. These novel characteristics may help achieve successful pulmonary vein (PV) isolation in difficult cases when conventional balloons were used.
Objective: This study aimed to investigate the differences in the lesion profiles, touch-up radiofrequency ablation (RFA) rate, and anatomical predictors of acute PV isolation between the POLAR and Arctic Front Advance Pro (AFA-Pro).
Europace
September 2025
Department of Cardiovascular Medicine, Institute of Science Tokyo, Tokyo, Japan.
Front Cardiovasc Med
August 2025
Department of Cardiology, MedStar Heart and Vascular Institute, Washington, DC, United States.
Background: Cryoballoon (CB) ablation is a well-established treatment for atrial fibrillation (AF). The Arctic Front Advance Pro™ (AFA-Pro) system, in use for over a decade, has demonstrated consistent efficacy and safety. Recently, the POLARx™, a novel CB system, has gained attention due to its advanced design and comparable clinical outcomes.
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September 2025
Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul Cerrahpasa University, Istanbul, Turkiye.
Atrial esophageal fistula (AEF) is a rare but life-threatening complication of atrial fibrillation (AF) ablation, linked to thermal injuries by conventional radiofrequency (RF) and cryo-balloon (CB) ablation techniques. AEF risk can be mitigated by considering several measures such as tailored power settings of ablation technique, mechanical displacement of esophagus, esophageal cooling, and alternative ablative techniques and energy sources. We review the current knowledge regarding AEF and esophageal thermal injuries as well as discussing the current research regarding a novel none-to-minimally thermal, myocardial tissue-selective modality known as pulsed-field ablation (PFA) which may mitigate such risks.
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