The Balloon Temperature During Cryoballoon Catheter Ablation And The Association Between Pulmonary Vein Anatomy And Balloon Temperature

Objective:Comparing the balloon temperature between cryoablations those completed pulmonary vein(PV)potential isolation with PV signals real-time mapped and cryoablations those completed PV potential isolation without PV signals mapped.And analyzing the association between PV anatomy and balloon temperature during cryoablation.Method:The anatomical parameters of PV were measured in pulmonary vein contrast-enhanced CT before cryotherapy.And the change of PV potential and balloon temperature during each cryoablation were recorded in detail.In the first part,the PVs those potential were isolated with PV signals real-time mapped during cryoablation were divided into group A;the PVs those potential were isolated without PV signals mapped during cryoablation were divided into group B.Comparing the balloon temperature of the freezing cycles which completed potential isolation between the two groups.In the second part,general linear regression models and multiple linear regression models were fitted to relate the PV anatomy with balloon temperature of the freezing cycles which completed potential isolation.Results:In the first part,341 pulmonary veins from 89 patients were enrolled in this study.Group A have 165 PVs,and Group B have 176 PVs.We known that,balloon temperatures during 30 seconds(-29.63±4.64℃ VS-27.62±5.32℃ P<0.01),60 seconds(-40.03±4.86℃ VS-37.88±5.81℃,P<0.01),and balloon nadir temperature(-48.00(-53.00～-43.00)℃ VS-45.00(-51.00-41.00)℃,P<0.01)were significantly lower in group A than group B.And the thaw times to 0℃[10.00(7.00～12.00)s VS 8.00(6.00～10.00)s,P<0.01]and the thaw times to 37℃(73.77±20.02s VS 62.64±19.49s,P<0.01)were significantly longer in group A than group B.In the second part,160 pulmonary veins from 41 patients were enrolled in this study.Positive correlations were found between PV orientation in the coronal plane(CSA)and balloon temperatures during 30 seconds(T30s),60 seconds(T60s)and balloon nadir temperature(BNT)(β=0.22 and P=0.01 for T30s,β=0.30 and P<0.01 for T60s,β=0.30 and P<0.01 for BNT).Inverse associations was found between CSA and the thaw times to 0℃(tto0),the thaw times to 37℃(tto37)(β=-0.40 and P<0.01 for tto0,β=-0.37 and P<0.01 for tto37).The long ostium diameter(D1)was negatively correlated with balloon temperatures during 30 seconds(T30s),60 seconds(T60s)and balloon nadir temperature(BNT)(β=-0.31 and P<0.01 for T30s,β=-0.28 and P<0.01 for T60s,β=-0.29 and P<0.01 for BNT),and positively correlated with the thaw times to 37 C(β=0.19,P=0.02).Conclusion:In the process of cryoablation,there are significantly differences in balloon temperature between cryoablations those completed PV potential isolation with PV signals real-time mapped and cryoablations those completed PV potential isolation without PV signals mapped.The PV orientation in the coronal plane(CSA)and the long ostium diameter(Dl)were associated with the balloon temperature during cryoablation,and the association between CSA and balloon temperature was more significant.