{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T14:17:55Z","timestamp":1765808275293,"version":"build-2065373602"},"reference-count":11,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Introduction: The aim of this study is to assess the accuracy of the injection-based occlusion (IBO) tool utilizing saline and glucose solution in verifying pulmonary vein (PV) occlusion during cryoballoon ablation guided by a novel dielectric system (KODEX\u2013EPD system). Methods: In this retrospective study, we enrolled 34 consecutive patients with paroxysmal atrial fibrillation (AF) who underwent their initial cryoballoon ablation procedure guided by the KODEX-EPD system. PV occlusion was firstly assessed by the IBO tool utilizing saline or glucose solution and then verified by direct contrast angiography. Patients were divided into two groups according to the fluid used in the IBO tool: the Saline Group and the Glucose Group. Results: The overall procedure time and fluoroscopy time were comparable between the Saline Group and the Glucose Group (113.7 \u00b1 18.3 vs. 108.4 \u00b1 15.9 min; p = 0.375 and 10.1 \u00b1 3.7 vs. 9.3 \u00b1 3.5 min; p = 0.559). The IBO tool was utilized a total of 138 times in the Saline Group and 135 times in the Glucose Group. When assessing PV occlusion, the IBO tool using saline demonstrated a sensitivity of 92.6% and a specificity of 95.2% compared to angiography. Similarly, the IBO tool utilizing glucose solution showed a sensitivity of 93.2% and a specificity of 96.1%. Conclusions: The IBO tool utilizing non-contrast fluid, saline and glucose solution, demonstrates a high level of sensitivity and specificity in accurately predicting PV occlusion during cryoablation procedures. Both the saline and glucose solutions used in the IBO tool show promising results in effectively assessing PV occlusion.<\/jats:p>","DOI":"10.3390\/jcdd10100427","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T08:10:19Z","timestamp":1697530219000},"page":"427","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Accuracy of the Injection-Based Occlusion Tool Utilizing Saline and Glucose Solution in Cryoballoon Ablation Guided by a Novel Dielectric Imaging System"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0869-8231","authenticated-orcid":false,"given":"Binfeng","family":"Mo","sequence":"first","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #1665 Kong Jiang Road, Shanghai 200092, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiali","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #1665 Kong Jiang Road, Shanghai 200092, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoming","family":"Lian","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #1665 Kong Jiang Road, Shanghai 200092, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingxing","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #1665 Kong Jiang Road, Shanghai 200092, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qunshan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #1665 Kong Jiang Road, Shanghai 200092, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yigang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #1665 Kong Jiang Road, Shanghai 200092, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1056\/NEJMoa1602014","article-title":"Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation","volume":"374","author":"Kuck","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1056\/NEJMoa2029554","article-title":"Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation","volume":"384","author":"Wazni","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1056\/NEJMoa2029980","article-title":"Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation","volume":"384","author":"Andrade","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1016\/j.jacep.2019.06.020","article-title":"High-Resolution Imaging of LA Anatomy Using a Novel Wide-Band Dielectric Mapping System: First Clinical Experience","volume":"5","author":"Maurer","year":"2019","journal-title":"JACC. Clin. Electrophysiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e010174","DOI":"10.1161\/CIRCEP.121.010174","article-title":"Accuracy and Acute Efficacy of the Novel Injection-Based Occlusion Algorithm in Cryoballoon Pulmonary Vein Isolation Guided by Dielectric Imaging","volume":"15","author":"Rottner","year":"2022","journal-title":"Circ. 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Electrophysiol. PACE"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e009219","DOI":"10.1161\/CIRCEP.120.009219","article-title":"Novel Wide-Band Dielectric Imaging System and Occlusion Tool to Guide Cryoballoon-Based Pulmonary Vein Isolation: Feasibility and First Insights","volume":"13","author":"Rillig","year":"2020","journal-title":"Circ. Arrhythmia Electrophysiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s00380-021-01902-2","article-title":"Fluoroscopy and contrast media use in cryoballoon ablation of atrial fibrillation using a novel imaging system","volume":"37","author":"Schillaci","year":"2022","journal-title":"Heart Vessel."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/10\/10\/427\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:08:02Z","timestamp":1760130482000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/10\/10\/427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,17]]},"references-count":11,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcdd10100427"],"URL":"https:\/\/doi.org\/10.3390\/jcdd10100427","relation":{},"ISSN":["2308-3425"],"issn-type":[{"type":"electronic","value":"2308-3425"}],"subject":[],"published":{"date-parts":[[2023,10,17]]}}}