Antiarrhythmic drugs were discontinued for at least five half-lives before the procedure. However, if the patient had hemodynamically unstable arrhythmias, the procedure was performed without discontinuing antiarrhythmic therapy. Procedures were performed under conscious sedation unless there was a need for epicardial mapping or hemodynamically unstable arrhythmias that may require electrical cardioversion. Otherwise, general anesthesia was used. A three-dimensional system (EnSite PrecisionTM Cardiac Mapping System, St. Jude Medical) was used for mapping in procedures other than CB ablation for AF. In cases where the three-dimensional mapping system was used, RF catheter ablation was performed via a contact force sensing catheter (the TactiCath Quartz open-irrigated contact force-sensing catheter). A second-generation 28-mm CB catheter (Arctic Front AdvanceTM, Medtronic) was used for pulmonary vein isolation in cases treated with CB for AF.
Arctic front advancetm
Manufactured by Medtronic
Sourced in United States
The Arctic Front AdvanceTM is a lab equipment product designed for low-temperature testing and evaluation. It provides a controlled environment for subjecting samples or materials to extreme cold conditions. The device's core function is to generate and maintain precise low-temperature settings to support various research and testing applications.
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4 protocols using arctic front advancetm
1
Catheter Ablation Procedure Protocols
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Antiarrhythmic drugs were discontinued for at least five half-lives before the procedure. However, if the patient had hemodynamically unstable arrhythmias, the procedure was performed without discontinuing antiarrhythmic therapy. Procedures were performed under conscious sedation unless there was a need for epicardial mapping or hemodynamically unstable arrhythmias that may require electrical cardioversion. Otherwise, general anesthesia was used. A three-dimensional system (EnSite PrecisionTM Cardiac Mapping System, St. Jude Medical) was used for mapping in procedures other than CB ablation for AF. In cases where the three-dimensional mapping system was used, RF catheter ablation was performed via a contact force sensing catheter (the TactiCath Quartz open-irrigated contact force-sensing catheter). A second-generation 28-mm CB catheter (Arctic Front AdvanceTM, Medtronic) was used for pulmonary vein isolation in cases treated with CB for AF.
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Antiarrhythmic drugs were discontinued for at least five half-lives before the procedure. However, if the patient had hemodynamically unstable arrhythmias, the procedure was performed without discontinuing antiarrhythmic therapy. Procedures were performed under conscious sedation unless there was a need for epicardial mapping or hemodynamically unstable arrhythmias that may require electrical cardioversion. Otherwise, general anesthesia was used. A three-dimensional system (EnSite PrecisionTM Cardiac Mapping System, St. Jude Medical) was used for mapping in procedures other than CB ablation for AF. In cases where the three-dimensional mapping system was used, RF catheter ablation was performed via a contact force sensing catheter (the TactiCath Quartz open-irrigated contact force-sensing catheter). A second-generation 28-mm CB catheter (Arctic Front AdvanceTM, Medtronic) was used for pulmonary vein isolation in cases treated with CB for AF.
2
Cryoballoon Ablation for Paroxysmal Atrial Fibrillation
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Two hundred and ninety-six consecutive patients with PAF referred for PVI were included prospectively. The participants were recruited from 2015 to 2017. Individuals with a previous history of AF ablation procedures were excluded. The study complied with the Declaration of Helsinki, and all patients provided written informed consent. The study protocol was approved by a local institutional review board. Antiarrhythmic drugs were discontinued for at least 5 half-lives before the procedure. All patients were treated with a 28 mm second-generation cryoballoon (Arctic Front AdvanceTM, Medtronic, Minneapolis, MN, USA). The procedure was performed under conscious sedation without stopping oral anticoagulation.
3
Pulmonary Vein Isolation Techniques
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Left atrial catheter ablation was performed using either radiofrequency ablation
or cryoballoon ablation at the discretion of the physician. For radiofrequency
ablation procedures, a 3.5-mm tip irrigated ablation catheter (Navistar
Thermocool, Biosense-Webster, Diamond Bar, California, USA) was used and placed
at the ostia of pulmonary vein (PV) to record PV potentials. For cryoablation
procedures, a 28-mm cryoballoon catheter (Arctic Front, Advance TM, Medtronic
Inc, Minneapolis, Minnesota, USA) was utilized to perform PVI. All patients
received circumferential ipsilateral PVI with guidance of electroanatomic
mapping (CARTO-3 system, Biosense-Webster, Diamond Bar, California, USA). The
endpoint of the PVI was the bidirectional conduction block from the atrium to
the PVs confirmed by Lasso catheter (Biosense-Webster, Diamond Bar, California,
USA).
or cryoballoon ablation at the discretion of the physician. For radiofrequency
ablation procedures, a 3.5-mm tip irrigated ablation catheter (Navistar
Thermocool, Biosense-Webster, Diamond Bar, California, USA) was used and placed
at the ostia of pulmonary vein (PV) to record PV potentials. For cryoablation
procedures, a 28-mm cryoballoon catheter (Arctic Front, Advance TM, Medtronic
Inc, Minneapolis, Minnesota, USA) was utilized to perform PVI. All patients
received circumferential ipsilateral PVI with guidance of electroanatomic
mapping (CARTO-3 system, Biosense-Webster, Diamond Bar, California, USA). The
endpoint of the PVI was the bidirectional conduction block from the atrium to
the PVs confirmed by Lasso catheter (Biosense-Webster, Diamond Bar, California,
USA).
4
Catheter Ablation of Atrial Fibrillation
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The CB catheter ablation of AF was performed according to the similar steps applied by Canpolat et al.’s study [15 (link)]. Briefly, all procedures were performed under conscious sedation. Transseptal puncture was performed with modified Brockenbrough technique (BRK-1, St. Jude Medical, St. Paul, MN, USA) and with fluoroscopy guidance. After a successful transseptal puncture, unfractionated heparin boluses were administered to maintain the activated clotting time of 300–350 s. All procedures have been performed by using the 28-mm second-generation CB catheter (Arctic Front AdvanceTM, Medtronic Inc., Minneapolis, MN, USA). Pulmonary vein conduction was evaluated by the circular mapping catheter (15-mm Achieve TM; Medtronic Inc., Minneapolis, MN, USA) during the procedure. Successful pulmonary vein isolation was defined as the elimination or dissociation of all the visible pulmonary vein potentials recorded by the circular mapping catheter.
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