Lesion durability after antral pulmonary vein isolation using a radiofrequency hot balloon catheter

J Interv Card Electrophysiol. 2021 Oct;62(1):21-30. doi: 10.1007/s10840-020-00857-0. Epub 2020 Sep 16.

Abstract

Purpose: Antral pulmonary vein isolation (PVI) using a radiofrequency hot balloon catheter (RHB) is a feasible therapeutic option for treating atrial fibrillation (AF). Lesion durability after antral RHB-PVI remains unknown. This study aimed to evaluate lesion durability and the associations between procedural characteristics after antral RHB-PVI.

Methods: A total of 200 patients received antral RHB-PVI using the single-shot technique between April 2016 and March 2018. Antral RHB-PVI was performed following a pre-specified protocol and RHB energy application was performed for a maximum of two times for each PV. Consecutive patients who underwent repeated procedures for recurrence of any type of atrial tachyarrhythmia were enrolled.

Results: Twenty-six (13%) patients underwent repeated ablation and 20 patient documented AF recurrence (AF group) and 6 patients documented non-AF recurrence (non-AF group). Repeated ablation was performed at a median (25th, 75th percentiles) of 378 days (217, 487) after the initial procedure and durable PVI was observed in 86 (83.5%) PVs. Durability reached 89.7% when PVI was achieved only using an RHB. In the AF group (79 PVs), durable PVI was observed in 62 (78.5%) PVs, whereas all 24 PVs were still isolated in the non-AF group. The majority of reconnection sites were around the superior PVs.

Conclusions: Antral RHB-PVI shows high lesion durability, especially with both inferior PVs.

Keywords: Antral pulmonary vein isolation; Atrial fibrillation; Durability; Radiofrequency hot balloon ablation; Reconnection site.

MeSH terms

  • Atrial Fibrillation* / diagnostic imaging
  • Atrial Fibrillation* / surgery
  • Catheter Ablation*
  • Catheters
  • Humans
  • Pulmonary Veins* / diagnostic imaging
  • Pulmonary Veins* / surgery
  • Recurrence
  • Treatment Outcome