Interventions
This resource on Pulmonary Vein Isolation (PVI) is an excerpt from the comprehensive EP Anesthesia CRNA Handbook. The handbook provides anesthesia and workflow guidance for electrophysiology teams performing procedures for…
This article explores quality improvement initiatives that enhance the safety and efficiency of electrical cardioversion for atrial fibrillation. Discusses standardized protocols, coordinated care processes, and workflow improvements that support better…
This article reviews quality improvement strategies designed to optimize the diagnosis and management of atrial fibrillation. Highlights evidence-based approaches that improve adherence to clinical guidance, reduce variation in care, and…
This article reviews evidence-based strategies for preventing cardiac implantable electronic device infections, including peri-procedural antibiotic use and antibacterial envelopes. Highlights quality improvement opportunities to reduce infection risk through standardized protocols…
This document provides a standardized protocol for measuring, correcting, and monitoring QTc intervals during initiation and maintenance of antiarrhythmic drug (AAD) therapy, with special considerations for atrial fibrillation and wide…
This resource outlines standardized workflows and smartphrase guidance for managing cardiac device alerts, including atrial and ventricular arrhythmias, ICD therapies, lead issues, and battery status. It supports consistent, efficient alert…
This SOP provides a concise, guideline-based framework for sudden cardiac death risk stratification and ICD indications across multiple cardiomyopathies, including ischemic and non-ischemic dilated cardiomyopathy, ARVC, HOCM, myotonic dystrophy, and…
There is a need to establish a standardized process for identifying, contacting, and re-engaging cardiac device patients who have become inactive in remote monitoring or clinic follow-up, in order to…
While the new guidelines provide excellent lifestyle changes (backed by evidence) for mitigation of atrial fibrillation, in clinic visits practitioners are often rushed for time, patients can feel scolded instead…
Journal Articles: Background: Pulmonary vein isolation (PVI) using the 2nd-generation cryoballoon (CB2) for the treatment of atrial fibrillation (AF) has demonstrated encouraging acute and mid-term results. However, follow-up data on outcomes beyond 1 year are sparse. We investigated the 3-year outcome after PVI using the CB2. Methods and Results: 100 patients with paroxysmal (PAF, 70/100 [70%] patients) or persistent AF (pAF, 30/100 [30%] patients) underwent CB2-based PVI in 2 experienced centers in Germany. Freeze-cycle duration was 240 s. After successful PVI a bonus freeze-cycle of the same duration was applied in the first 71 patients but was omitted in the following 29 patients. Phrenic nerve palsy occurred in 3 patients (3%); 2 patients were lost to follow-up. After a median follow-up of 38 (29–50) months, 59/98 (60.2%) patients remained in stable sinus rhythm (PAF: 48/70 (69%), pAF: 11/28 (39%) P=0.0084). In 32/39 (77%) patients with arrhythmia recurrence, a second ablation procedure using radiofrequency energy was conducted. Persistent PVI was noted in 76/125 (61%) PVs. After a mean of 1.37±0.6 procedures and a median follow-up of 35 (25–39) months, 77/98 (78.6%) patients remained in stable sinus rhythm (PAF: 56/70 (80%), pAF: 20/28 (71%), P=0.0276). Conclusions: CB2-based PVI resulted in a 60.2% single-procedure and a 78.6% multiple-procedure success rate after 3 years. Repeat procedures demonstrated a high rate of durable PVI.