Four typical pulmonary venous pressure curves displaying the level of occlusion during atrial fibrillation ablation by cryoballoon

J Arrhythm. 2023 Sep 20;39(6):997-1000. doi: 10.1002/joa3.12926. eCollection 2023 Dec.

Abstract

Background: Cryoballoon ablation is safe and effective for pulmonary vein isolation in patients with symptomatic drug-refractory paroxysmal atrial fibrillation. To monitor adhesion between the balloon and the pulmonary vein, an alternative technique to pulmonary venography is to analyze changes in the pressure curve.

Methods: We have described the adhesion level characterized by four types of pressure waveforms.

Results: These correlated with the extent of contrast agent leakage (Cohen's kappa of 0.81 [IC 95%: 0.63-0.99]).

Conclusion: Monitoring the venous pressure curve is easy to perform and has the advantage of being able to detect balloon movement during the first few seconds of treatment.

Keywords: atrial fibrillation; catheter ablation; cryotherapy; pulmonary vein; venography.