Abstract 599 A novel wide-band dielectric imaging system and occlusion tool to guide cryoballoon-based pulmonary vein isolation: feasibility and first insights

Clin Res Cardiol (2021) DOI DOI https://doi.org/10.1007/s00392-021-01843-w
A novel wide-band dielectric imaging system and occlusion tool to guide cryoballoon-based pulmonary vein isolation: feasibility and first insights
L. Rottner¹, M. Nodorp¹, P. Münkler², L. Dinshaw², R. Schleberger², M. Lemoine², M. Nies¹, T. Risius³, S. Blankenberg¹, P. Kirchhof¹, B. Reißmann¹, A. Rillig², A. Metzner²
¹Klinik für Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg GmbH, Hamburg; ²Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herz- und Gefäßzentrum Hamburg GmbH, Hamburg; ³Kardiologische Praxis Orchideenstieg, Hamburg;
Background: Cryoballoon (CB) pulmonary vein isolation (PVI) is an established treatment option for symptomatic atrial fibrillation (AF). Currently, cryoballoon ablation relies on dye injections to verify occlusion of the pulmonary vein (PV) prior to freezing. Objective: We report on our first clinical experience with a novel wide-band dielectric imaging system (KODEX-EPD) designed to detect PV occlusion without fluoroscopy. Methods: Data were extracted from consecutive patients undergoing a first CB atrial fibrillation ablation using the KODEX-EPD system and its occlusion tool. Data were analyzed to determine the usefulness of the system and the concordance of PV occlusion using the KODEX-EPD occlusion tool compared to PV angiography. Results: Eighty-two patients (28 female, age 65 [57;72], 42 (51%) paroxysmal AF, left atrial diameter 44±9 mm) were studied, and 328 PV were ablated using fourth generation CB. Both imaging modalities were analyzable in 317/328 (97%) PVs. KODEX-EPD identified PV occlusion at the first attempt in 259/317 PVs and angiography identified occlusion in 288/317 PVs. PV occlusion verified by both, KODEX-EPD and angiography was seen in 230/288 (80%) PVs. All veins were successfully isolated. Median procedure time was 87 [76;104] min, mean fluoroscopy time 17 [14;21] min and mean dose area product 649 [438;1013] cGycm². Conclusion: The novel, non-fluoroscopic KODEX-EPD PV occlusion tool detects occlusion of PVs by the CB with good accuracy in routine care.
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