Termination of perioperative atrial fibrillation with epicardial cooling in the oblique sinus: A first-in-human feasibility study

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Rhythm O2 Pub Date : 2025-04-01 DOI:10.1016/j.hroo.2025.01.017

Alejandro Trainini MD , Miragaya Nicolàs MD , Crespo Fabián MD , Delgado Elìas Lorena MD , Heredia Florencia CCP , Miranda Hernán CCP , Brodaric María Magdalena MD , Ciscato Julio MD , Adetola Ladejobi MD , Ammar Killu MBBS, FHRS , Juan Crestanello MD , Jason Tri , Jeff Rynbrandt BS, MBA , Samuel Asirvatham MD, FHRS , Paul Friedman MD, FHRS , Benjamin Elencwajg MD

{"title":"Termination of perioperative atrial fibrillation with epicardial cooling in the oblique sinus: A first-in-human feasibility study","authors":"Alejandro Trainini MD , Miragaya Nicolàs MD , Crespo Fabián MD , Delgado Elìas Lorena MD , Heredia Florencia CCP , Miranda Hernán CCP , Brodaric María Magdalena MD , Ciscato Julio MD , Adetola Ladejobi MD , Ammar Killu MBBS, FHRS , Juan Crestanello MD , Jason Tri , Jeff Rynbrandt BS, MBA , Samuel Asirvatham MD, FHRS , Paul Friedman MD, FHRS , Benjamin Elencwajg MD","doi":"10.1016/j.hroo.2025.01.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Postoperative atrial fibrillation (AF) is associated with prolonged hospitalization, stroke and expense. We have previously demonstrated the effectiveness of cooling the oblique sinus to terminate AF in animal models.</div></div><div><h3>Objective</h3><div>The study sought to determine whether cooling can terminate intraoperative AF in humans undergoing cardiac surgery.</div></div><div><h3>Methods</h3><div>Patients presenting for clinically indicated cardiac surgery with a history of atrial fibrillation were enrolled. During surgery, before bypass, AF was induced if not present, and a 1 × 1 inch cooling device was placed in the oblique sinus that cooled to 5 to 10 °C at the device-tissue interface. Due to the pandemic, remote, real-time monitoring was used.</div></div><div><h3>Results</h3><div>Four patients (all women, mean age 69.3 years) underwent 8 AF inductions. Five (63%) of 8 episodes were terminated with cooling, with average time to termination (after 30 seconds of sustained arrhythmia) of 21 seconds. Of the 3 failed episodes, 1 may have been a type II termination, 1 organized to flutter, and 1 failed to cool for technical reasons. There were no procedure-related complications.</div></div><div><h3>Conclusion</h3><div>Termination of perioperative atrial fibrillation with epicardial cooling in the oblique sinus is feasible and appears safe in this very early first-in-human study.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 4","pages":"Pages 444-449"},"PeriodicalIF":2.5000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart Rhythm O2","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666501825000261","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Postoperative atrial fibrillation (AF) is associated with prolonged hospitalization, stroke and expense. We have previously demonstrated the effectiveness of cooling the oblique sinus to terminate AF in animal models.

Objective

The study sought to determine whether cooling can terminate intraoperative AF in humans undergoing cardiac surgery.

Methods

Patients presenting for clinically indicated cardiac surgery with a history of atrial fibrillation were enrolled. During surgery, before bypass, AF was induced if not present, and a 1 × 1 inch cooling device was placed in the oblique sinus that cooled to 5 to 10 °C at the device-tissue interface. Due to the pandemic, remote, real-time monitoring was used.

Results

Four patients (all women, mean age 69.3 years) underwent 8 AF inductions. Five (63%) of 8 episodes were terminated with cooling, with average time to termination (after 30 seconds of sustained arrhythmia) of 21 seconds. Of the 3 failed episodes, 1 may have been a type II termination, 1 organized to flutter, and 1 failed to cool for technical reasons. There were no procedure-related complications.

Conclusion

Termination of perioperative atrial fibrillation with epicardial cooling in the oblique sinus is feasible and appears safe in this very early first-in-human study.

查看原文本刊更多论文

斜窦心外膜冷却术终止围手术期心房颤动：首次人体可行性研究

背景术后心房颤动（AF）与住院时间延长、卒中和费用相关。我们之前已经在动物模型中证明了冷却斜窦以终止房颤的有效性。目的本研究旨在确定冷却是否可以终止心脏手术患者术中房颤。方法纳入有房颤病史的临床指征心脏手术患者。手术期间，在搭桥前，如果不存在房颤，则诱导房颤，并将1 × 1英寸的冷却装置放置在斜窦中，在装置-组织界面处冷却至5至10°C。由于疫情大流行，采用了远程实时监测。结果4例患者（均为女性，平均年龄69.3岁）共8次房颤诱导。8次发作中有5次（63%）以冷却结束，平均结束时间（持续心律失常30秒后）为21秒。在3次失败的事件中，1次可能是II型终止，1次组织颤振，1次由于技术原因未能冷却。无手术相关并发症。结论通过斜窦心外膜冷却术终止围手术期心房颤动是可行的，并且在这项早期的首次人体研究中是安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊