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Leitfaden zur sicheren und effizienten Kryoballon-Vorhofflimmerablation

Praktisches Vorgehen, Tipps und Tricks

Practical guide for safe and efficient cryoballoon ablation for atrial fibrillation

Practical procedure, tips and tricks

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Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Zusammenfassung

Die kryoballonbasierte Vorhofflimmerablation wird neben der Hochfrequenzstromablation in den aktuellen Leitlinien zur Vorhofflimmertherapie empfohlen und hat sich in der klinischen Routine vieler Zentren für die Index-Pulmonalvenenisolation als ein Standardverfahren etabliert. Durch ein systematisches Vorgehen kann eine sichere, vereinfachte und oftmals dauerhafte Pulmonalvenenisolation erreicht werden. Dieser Übersichtartikel bietet einen praktischen Leitfaden für alle Arbeitsschritte einer kryoballonbasierten Pulmonalvenenisolation und geht dabei auch auf die präprozedurale Vorbereitung sowie die postinterventionelle Nachsorge ein. Berücksichtigt werden beide aktuell auf dem Markt verfügbaren Kryoballonsysteme.

Abstract

In the current guidelines on treatment of atrial fibrillation, cryoballoon-based catheter ablation of atrial fibrillation is recommended in addition to radiofrequency ablation and has become established as a standard procedure in the clinical routine of many centers for index pulmonary vein isolation. A safe, simplified and often durable pulmonary vein isolation can be achieved by a systematic approach. This review article provides a practical guide for all steps of cryoballoon-based pulmonary vein isolation, including preprocedural preparation and postinterventional follow-up. Both cryoballoon systems currently available on the market are considered.

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Author information

Author notes

  1. Tilman Maurer

    Present address: Klinik für Kardiologie, Asklepios Klinik St. Georg, Hamburg, Deutschland

Authors and Affiliations

  1. Med. Klinik III, Markuskrankenhaus, Cardioangiologisches Centrum Bethanien – CCB, Wilhelm-Epstein-Str. 4, 60431, Frankfurt, Deutschland

    Julian Chun & Stefano Bordignon

  2. Universitäres Herzzentrum Hamburg, Universitätsklinikum Eppendorf, Hamburg, Deutschland

    Andreas Rillig & Andreas Metzner

  3. Klinik für Kardiologie, Herz- und Gefäßzentrum Bad Segeberg, Bad Segeberg, Deutschland

    Leon Iden

  4. Medizinische Klinik II, Klinikum Coburg GmbH, Coburg, Deutschland

    Sonia Busch

  5. Abteilung für Elektrophysiologie, Herzzentrum der Uniklinik Köln, Köln, Deutschland

    Daniel Steven

  6. Sektion für Elektrophysiologie, Medizinische Klinik II, Universitäres Herzzentrum Lübeck, Universitätsklinikum Schleswig-Holstein (UKSH), Lübeck, Deutschland

    Julian Chun & Roland R. Tilz

  7. Klinik für Kardiologie, Herzzentrum Niederrhein, HELIOS Klinikum Krefeld, Krefeld, Deutschland

    Dong-In Shin

  8. Center for Clinical Medicine Witten-Herdecke, University Faculty of Health, Wuppertal, Deutschland

    Dong-In Shin

  9. Medizinische Klinik und Poliklinik I, LMU Klinikum der Universität München, München, Deutschland

    Heidi Estner

  10. Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, München, Deutschland

    Felix Bourier

  11. Hannover Herzrhythmus Centrum, Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover, Deutschland

    David Duncker

  12. Klinik für Elektrophysiologie/Rhythmologie, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland

    Philipp Sommer

  13. Klinik für Innere Medizin – Kardiologie und konservative Intensivmedizin, Vivantes Klinikum Am Urban, Berliner-Herzrhythmus-Zentrum, Berlin, Deutschland

    Nils-Christian Ewertsen

  14. Elektrophysiologie Bremen, Bremen, Deutschland

    Henning Jansen

  15. Klinik für Innere Medizin, Universitätsklinikum Gießen, Gießen, Deutschland

    Victoria Johnson

  16. Abteilung für Rhythmologie, Herzzentrum HELIOS Leipzig, Leipzig, Deutschland

    Livio Bertagnolli

  17. Med. Klinik m.S. Kardiologie u. Angiologie, Charité – Universitätsmedizin Medizin Berlin, Berlin, Deutschland

    Till Althoff

Authors
  1. Julian Chun
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  2. Tilman Maurer
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  3. Andreas Rillig
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  4. Stefano Bordignon
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  5. Leon Iden
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  6. Sonia Busch
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  7. Daniel Steven
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  8. Roland R. Tilz
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  9. Dong-In Shin
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  10. Heidi Estner
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  11. Felix Bourier
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  12. David Duncker
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  13. Philipp Sommer
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  14. Nils-Christian Ewertsen
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  15. Henning Jansen
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  16. Victoria Johnson
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  17. Livio Bertagnolli
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  18. Till Althoff
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  19. Andreas Metzner
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Corresponding author

Correspondence to Julian Chun.

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Interessenkonflikt

J. Chun, T. Maurer, A. Rillig, S. Bordignon, L. Iden, S. Busch, D. Steven, R.R. Tilz, D.-I. Shin, H. Estner, F. Bourier, D. Duncker, P. Sommer, N.-C. Ewertsen, H. Jansen, V. Johnson, L. Bertagnolli, T. Althoff und A. Metzner geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Supplementary Information

Leitfaden zur sicheren Intubation der inferioren Pulmonalvenen.

Darstellung zur Anlage einer Z Naht am Ende der Kryoballon Vorhofflimmer-Ablation.

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Chun, J., Maurer, T., Rillig, A. et al. Leitfaden zur sicheren und effizienten Kryoballon-Vorhofflimmerablation. Herzschr Elektrophys 32, 550–562 (2021). https://doi.org/10.1007/s00399-021-00820-0

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  • DOI: https://doi.org/10.1007/s00399-021-00820-0

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