Clinically Manifesting Air Embolisms in Cryoballoon Ablation: Can Novel Water Buckets Reduce the Risk?

Shinsuke Miyazaki, Kanae Hasegawa, Moe Mukai, Eri Ishikawa, Daisetsu Aoyama, Minoru Nodera, Kenichi Kaseno, Kentaro Ishida, Hiroyasu Uzui, Hiroshi Tada

Journal: JACC. Clinical electrophysiology 2021;6(9):1067-1072

PMID: 32972540

Free Full Text on Elsevier Science View on PubMed

Abstract

Air embolisms can lead to lethal results; however, few reports have systemically investigated this issue. Of 348 consecutive patients with atrial fibrillation who underwent cryoballoon ablation, procedures were performed conventionally in 251 patients. In the remaining 97 patients, a water bucket was used while inserting the cryoballoon into the sheath. A total of 10 coronary air embolisms with ST-segment elevation in the inferior leads were observed among 9 (2.6%) patients. Multiple air bubbles were identified in 2 patients on emergent coronary angiography. All recovered under conservative treatment without any sequela. The incidence decreased when using the water bucket (1 of 97 [1.03%] vs. 8 of 251 [3.2%], p = 0.454).

Address: Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan. Electronic address: [email protected].; Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.

DOI: 10.1016/j.jacep.2020.07.012

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MeSH Terms: Atrial Fibrillation, Catheter Ablation, Cryosurgery, Embolism, Air, Humans, Pulmonary Veins, Treatment Outcome, Water