UPMC Physician Resources
Case Study: Cryoablation for Atrial Fibrillation
Samir Saba, MD
A 49 year old woman was referred to UPMC for curative treatment of atrial fibrillation in the form of pulmonary vein isolation.
She had a history of:
- Rheumatic heart disease status post subacute bacterial endocarditis requiring open-heart surgery and replacement of her mitral valve with a St. Jude Medical bi-leaflet mechanical valve.
- Paroxysmal atrial fibrillation failing treatment for a year with antiarrhythmic medications.
The evaluation
The patient was obese but otherwise in good health with a BMI of 46.1.
By transesophageal echocardiography, she had:
- A normal left ventricular ejection fraction.
- A well-seated mechanical mitral valve with normal function.
- No clots in the left atrial appendage (figure 1).
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| Figure 1: Transesophageal echocardiography |
The CT scan of her chest (figure 2) showed normal pulmonary venous anatomy with a right intermediate pulmonary vein emptying ostially into the right superior pulmonary vein.
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| Figure 2: CT scan |
The procedure
The patient was taken into the lab and underwent trans-septal left atrial catheterization under intracardiac echocardiographic guidance.
She underwent pulmonary vein isolation using the 23 mm Arctic Front cryoballoon catheter (figure 3).
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| Figure 3: Cryoballoon catheter deployment |
The results
At the end of the procedure, all four pulmonary veins were completely isolated.
She was restated on her anticoagulation with Coumadin® and was discharged home as soon as her anticoagulation was therapeutic.
© 2011 UPMC
Presenter
Dr. Samir Saba (BE 1989, MD 1993) received his Bachelors degree in Electrical Engineering in 1985 from the American University of Beirut and his medical degree in 1993 from the same institution. He then finished his training in Internal Medicine (1993-1996), in Cardiolovascular Diseases ...For More Information
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