Author
Marcus L. Koller
Bio: Marcus L. Koller is an academic researcher. The author has contributed to research in topics: Pulmonary vein & Catheter ablation. The author has an hindex of 5, co-authored 7 publications receiving 489 citations.
Papers
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TL;DR: Pulmonary vein isolation with a new cryoballoon technique is feasible and sinus rhythm can be maintained in the majority of patients with PAF by circumferential PVI using a cryoablation system.
448 citations
TL;DR: The current report underlines the importance of a patient-tailored ablation approach and suggests that cryothermic balloon technology may be more applicable in delicate cardiac structures by developing new anatomically adapted balloon shapes and sizes.
Abstract: Trigger sources of paroxysmal atrial fibrillation (PAF) are not limited to a pulmonary vein origin and may be achievable by cardiac vascular structures like the coronary sinus (CS), the vena cava superior and in some rare cases by a persistent left superior vena cava (LSVC). Cryoballoon ablation has been shown to be effective in pulmonary vein isolation. We report an unusual case of using this technique in the dilated CS in case of a persistent LSVC. A 64 year old patient presented PAF recurrences after cryo pulmonary vein isolation 4 months before. A maintaining pulmonary vein isolation could be demonstrated by transseptal mapping. Further bi-atrial mapping localized repetitive atrial trigger activity in a dilated CS proceeding to a LSVC. A cryoballoon was deployed in the CS target area and during cryoablation the triggered activity suspended. Ablation side effects were excluded by coronary angiography. During a follow up time of 8 months the patient has remained free of PAF recurrences. The current report underlines the importance of a patient-tailored ablation approach. Cryothermic balloon technology may be more applicable in delicate cardiac structures by developing new anatomically adapted balloon shapes and sizes.
14 citations
TL;DR: Schumacher et al. as mentioned in this paper proposed balloon-based catheter ablation for atrial fibrillation, which allows for a single shot PVI by placing the balloon at the pulmonary vein ostium and ablating circumferentially around the PV ostia with a single energy application.
Abstract: Pulmonary vein isolation (PVI) is the mainstay of catheter ablation for atrial fibrillation. In an effort to overcome the shortcomings of drawing a continuous line around the pulmonary vein (PV) ostia by point-by-point focal radiofrequency catheter ablation, research in the interventional electrophysiology field currently focuses on developing new energy sources and catheter designs to achieve PVI safer, faster, and with equal efficacy as compared with the conventional radiofrequency approach. In that respect, balloon-based catheter ablation systems are particularly promising because they allow for a ‘single shot’ PVI by placing the balloon at the PV ostium and ablating circumferentially around the PV ostia with a single energy application. Balloon-based catheter systems using various energy sources (cryothermal energy, non-focused ultrasound, highly focused ultrasound, laser, radiofrequency) have been developed or are currently under investigation.1 With regard to safety aspects, cryothermal energy may have advantages over other energy sources since both human and experimental animal data have demonstrated that the risk for PV stenosis,2 atrio-oesophageal fistulae,3 and thrombus formation4 is extremely low to absent …
*Corresponding author. Tel: + 49 9771 66 2602, Fax: + 49 9771 66 2605, Email schumacher{at}kardiologie-bad-neustadt.de
14 citations
TL;DR: “Redo” ablation using cryoballoon technology may be an effective and safe method to treat patients with recurrence of paroxysmal AF after cryoballsoon PVI.
Abstract: Background
Pulmonary vein (PV) isolation with the cryoballoon technique is an effective and safe method to treat patients with paroxysmal atrial fibrillation (AF). However, the optimal treatment strategy for patients with recurrences after this ablation is unclear.
11 citations
TL;DR: Assessing the feasibility of a new magnetic navigation system to enable intracoronary guidewire deployment and PCI in daily clinical practice found magnetic guided PCI is useful in selected patients and success is less likely in evidence of a subtotal occlusion.
Abstract: Aims:Percutaneous coronary intervention (PCI) has been broadly established and often includes highly complex stenoses that require difficult navigation. The purpose of this study is to assess the feasibility of a new magnetic navigation system (MNS) to enable intracoronary guidewire deployment and PCI in daily clinical practice and to compare the 2D guidance to the virtual 3D angioscopy feature.
Methods and Results:We included 30 consecutive patients (pt) in whom 36 coronary arteries were PCI targets. Patients were randomized to guidewire steering by either 2D guidance or virtual 3D angioscopy (33%).
In 31/36 (86%) interventions the MNS guidewire successfully passed the culprit stenosis and the procedure was accomplished by PCI. In 5/30 pt an MNS multivessel intervention was performed. Three of 5 unsuccessful procedures failed due to an unsuccessful recanalization of a subtotal chronic occlusion including 1 pt who required surgical intervention. In 2/36 procedures the magnetic guided intervention was performed effectively after prior conventional failure related to complex anatomy. The contrast medium amount needed to position the magnetic guidewire was 60 ± 101 mL in 2D accomplished interventions vs. 14 ± 15 mL in 3D procedures (p < 0.05). In 3 pt the MNS did not harm the implanted pacemaker or defibrillator system.
Conclusion:Magnetic guided PCI is useful in selected patients. In our experience, success is less likely in evidence of a subtotal occlusion.
9 citations
Cited by
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Johns Hopkins University1, University of Barcelona2, St George's, University of London3, Taipei Veterans General Hospital4, Maastricht University5, Washington University in St. Louis6, Imperial College London7, University of Virginia8, Virginia Commonwealth University9, Thomas Jefferson University10, Beaumont Hospital11, University of Bordeaux12, Leipzig University13, University of Oklahoma14, University of Michigan15, Royal Melbourne Hospital16, University College Dublin17, Korea University18, University of Birmingham19, University of Münster20, University of Western Ontario21, Cleveland Clinic22, Harvard University23, University of Pennsylvania24, Northwestern University25, Université de Montréal26, Mayo Clinic27, Icahn School of Medicine at Mount Sinai28, University of California, Los Angeles29, National Yang-Ming University30, Loyola University Chicago31
TL;DR: This 2012 Consensus Statement is to provide a state-of-the-art review of the field of catheter and surgical ablation of AF and to report the findings of a Task Force, convened by the Heart Rhythm Society, the European Heart Rhythm Association, and the European Cardiac Arrhythmia Society and charged with defining the indications, techniques, and outcomes of this procedure.
Abstract: During the past decade, catheter ablation of atrial fibrillation (AF) has evolved rapidly from an investigational procedure to its current status as a commonly performed ablation procedure in many major hospitals throughout the world. Surgical ablation of AF, using either standard or minimally invasive techniques, is also performed in many major hospitals throughout the world.
In 2007, an initial Consensus Statement on Catheter and Surgical AF Ablation was developed as a joint effort of the Heart Rhythm Society, the European Heart Rhythm Association, and the European Cardiac Arrhythmia Society.1 The 2007 document was also developed in collaboration with the Society of Thoracic Surgeons and the American College of Cardiology. Since the publication of the 2007 document, there has been much learned about AF ablation, and the indications for these procedures have changed. Therefore the purpose of this 2012 Consensus Statement is to provide a state-of-the-art review of the field of catheter and surgical ablation of AF and to report the findings of a Task Force, convened by the Heart Rhythm Society, the European Heart Rhythm Association, and the European Cardiac Arrhythmia Society and charged with defining the indications, techniques, and outcomes of this procedure. Included within this document are recommendations pertinent to the design of clinical trials in the field of AF ablation, including definitions relevant to this topic.
This statement summarizes the opinion of the Task Force members based on an extensive literature review as well as their own experience. It is directed to all health care professionals who are involved in the care of patients with AF, particularly those who are undergoing, or are being considered for, catheter or surgical ablation procedures for AF. This statement is not intended to recommend or promote catheter ablation of AF. Rather the ultimate judgment regarding care of a particular patient …
2,754 citations
Johns Hopkins University1, Leipzig University2, Korea University3, Yale University4, West Virginia University5, University of Barcelona6, St George's, University of London7, Indiana University8, National Yang-Ming University9, Cleveland Clinic10, Aarhus University11, University at Buffalo12, Imperial College London13, Primary Children's Hospital14, Erasmus University Rotterdam15, Yeshiva University16, Ghent University17, Baylor University18, Virginia Commonwealth University19, Harvard University20, Federal University of São Paulo21, University of California, San Francisco22, Beaumont Hospital23, Boston University24, University of Oklahoma25, Carlos III Health Institute26, University of Michigan27, University of Melbourne28, Saint Louis University29, Université de Montréal30, University of Pennsylvania31, McGill University32, Mayo Clinic33, Lahey Hospital & Medical Center34, Royal Adelaide Hospital35, University of Milan36, University of Toronto37, Loyola University Chicago38, Jikei University School of Medicine39
TL;DR: This 2017 Consensus Statement is to provide a state-of-the-art review of the field of catheter and surgical ablation of AF and to report the findings of a writing group, convened by these five international societies.
1,626 citations
Johns Hopkins University1, University of Pennsylvania2, Mayo Clinic3, University of Barcelona4, St George's, University of London5, Maastricht University6, Cleveland Clinic7, University of Virginia8, Baylor University9, Virginia Commonwealth University10, Thomas Jefferson University11, Beaumont Hospital12, University of Bordeaux13, Leipzig University14, University of Oklahoma15, University of Michigan16, Royal Melbourne Hospital17, University College Dublin18, Korea University19, University of Münster20, University of Birmingham21, University of Western Ontario22, Imperial College London23, Harvard University24, Northwestern University25, National Yang-Ming University26, Washington University in St. Louis27, Université de Montréal28, Icahn School of Medicine at Mount Sinai29, University of California, Los Angeles30, Loyola University Chicago31
TL;DR: A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation, developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology and the European Cardiac Arrhythmia Society (ECAS), was published in this paper.
1,271 citations
TL;DR: The STOP AF trial demonstrated that cryoballoon ablation is a safe and effective alternative to antiarrhythmic medication for the treatment of patients with symptomatic paroxysmal AF, for whom at least one antiarrHythmic drug has failed, with risks within accepted standards for ablation therapy.
748 citations
Johns Hopkins University1, University of Barcelona2, St George's, University of London3, Maastricht University4, Washington University in St. Louis5, Imperial College London6, University of Virginia7, Baylor University8, Virginia Commonwealth University9, Thomas Jefferson University10, Beaumont Hospital11, University of Bordeaux12, Leipzig University13, University of Oklahoma14, University of Michigan15, Royal Melbourne Hospital16, University College Dublin17, Korea University18, University of Münster19, University of Birmingham20, University of Western Ontario21, Cleveland Clinic22, Harvard University23, University of Pennsylvania24, Northwestern University25, Université de Montréal26, Mayo Clinic27, Icahn School of Medicine at Mount Sinai28, University of California, Los Angeles29, National Yang-Ming University30, Loyola University Chicago31
TL;DR: This is a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation, developed in partnership with the European Heart Rhythm Association (EHRA).
Abstract: This is a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation, developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology and the European Cardiac Arrhythmia Society (ECAS), and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). This is endorsed by the governing bodies of the ACC Foundation, the AHA, the ECAS, the EHRA, the STS, the APHRS, and the HRS.
441 citations