Lesion Durability After Antral Pulmonary Vein Isolation Using a Radiofrequency Hot Balloon Catheter

Overview

Journal J Interv Card Electrophysiol

Publisher Springer

Date 2020 Sep 17

PMID 32939701

Citations 2

Authors

Hiro Yamasaki

Kazutaka Aonuma

Yasutoshi Shinoda

Yuki Komatsu

Hiroaki Watanabe

Akira Kimata

Satoshi Aita

Masayuki Hattori

Takeshi Machino

Miyako Igarashi

Yukio Sekiguchi

Akihiko Nogami

Masaki Ieda

Affiliations

Soon will be listed here.

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.

Citing Articles

Current Balloon Devices for Ablation of Atrial Fibrillation.

Nakahara S, Hori Y, Fukuda R, Sato H, Aoki H, Kondo Y Rev Cardiovasc Med. 2024; 25(1):34.

PMID: 39077656 PMC: 11262367. DOI: 10.31083/j.rcm2501034.

Effects of Hot Balloon vs. Cryoballoon Ablation for Atrial Fibrillation: A Systematic Review, Meta-Analysis, and Meta-Regression.

Peng X, Liu X, Tian H, Chen Y, Li X Front Cardiovasc Med. 2022; 8:787270.

PMID: 34977192 PMC: 8714841. DOI: 10.3389/fcvm.2021.787270.

References

Reddy V, Sediva L, Petru J, Skoda J, Chovanec M, Chitovova Z . Durability of Pulmonary Vein Isolation with Cryoballoon Ablation: Results from the Sustained PV Isolation with Arctic Front Advance (SUPIR) Study. J Cardiovasc Electrophysiol. 2015; 26(5):493-500. DOI: 10.1111/jce.12626. View

Dukkipati S, Neuzil P, Kautzner J, Petru J, Wichterle D, Skoda J . The durability of pulmonary vein isolation using the visually guided laser balloon catheter: multicenter results of pulmonary vein remapping studies. Heart Rhythm. 2012; 9(6):919-25. DOI: 10.1016/j.hrthm.2012.01.019. View

Sohara H, Ohe T, Okumura K, Naito S, Hirao K, Shoda M . HotBalloon Ablation of the Pulmonary Veins for Paroxysmal AF: A Multicenter Randomized Trial in Japan. J Am Coll Cardiol. 2016; 68(25):2747-2757. DOI: 10.1016/j.jacc.2016.10.037. View

Yamasaki H, Aonuma K, Shinoda Y, Komatsu Y, Masuda K, Hashimoto N . Initial Result of Antrum Pulmonary Vein Isolation Using the Radiofrequency Hot-Balloon Catheter With Single-Shot Technique. JACC Clin Electrophysiol. 2019; 5(3):354-363. DOI: 10.1016/j.jacep.2019.01.017. View

Kiuchi K, Kircher S, Watanabe N, Gaspar T, Rolf S, Arya A . Quantitative analysis of isolation area and rhythm outcome in patients with paroxysmal atrial fibrillation after circumferential pulmonary vein antrum isolation using the pace-and-ablate technique. Circ Arrhythm Electrophysiol. 2012; 5(4):667-75. DOI: 10.1161/CIRCEP.111.969923. View

Kuck K, Brugada J, Furnkranz A, Metzner A, Ouyang F, Chun K . Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation. N Engl J Med. 2016; 374(23):2235-45. DOI: 10.1056/NEJMoa1602014. View

Dukkipati S, Cuoco F, Kutinsky I, Aryana A, Bahnson T, Lakkireddy D . Pulmonary Vein Isolation Using the Visually Guided Laser Balloon: A Prospective, Multicenter, and Randomized Comparison to Standard Radiofrequency Ablation. J Am Coll Cardiol. 2015; 66(12):1350-60. DOI: 10.1016/j.jacc.2015.07.036. View

Aryana A, Mugnai G, Singh S, Pujara D, de Asmundis C, Singh S . Procedural and biophysical indicators of durable pulmonary vein isolation during cryoballoon ablation of atrial fibrillation. Heart Rhythm. 2015; 13(2):424-32. DOI: 10.1016/j.hrthm.2015.10.033. View

Miyazaki S, Taniguchi H, Hachiya H, Nakamura H, Takagi T, Hirao K . Clinical recurrence and electrical pulmonary vein reconnections after second-generation cryoballoon ablation. Heart Rhythm. 2016; 13(9):1852-7. DOI: 10.1016/j.hrthm.2016.05.025. View

10.

Aryana A, Singh S, Mugnai G, de Asmundis C, Kowalski M, Pujara D . Pulmonary vein reconnection following catheter ablation of atrial fibrillation using the second-generation cryoballoon versus open-irrigated radiofrequency: results of a multicenter analysis. J Interv Card Electrophysiol. 2016; 47(3):341-348. DOI: 10.1007/s10840-016-0172-z. View

11.

Sohara H, Takeda H, Ueno H, Oda T, Satake S . Feasibility of the radiofrequency hot balloon catheter for isolation of the posterior left atrium and pulmonary veins for the treatment of atrial fibrillation. Circ Arrhythm Electrophysiol. 2009; 2(3):225-32. DOI: 10.1161/CIRCEP.108.817205. View

12.

Yamasaki H, Adachi T, Komatsu Y, Kuroki K, Sekiguchi Y, Nogami A . Unexpected Electrical Isolation of the Superior Vena Cava During Radiofrequency Hot Balloon Ablation in the Right Superior Pulmonary Vein. Circ J. 2017; 81(5):763-765. DOI: 10.1253/circj.CJ-16-1055. View

13.

Reddy V, Neuzil P, dAvila A, Laragy M, Malchano Z, Kralovec S . Balloon catheter ablation to treat paroxysmal atrial fibrillation: what is the level of pulmonary venous isolation?. Heart Rhythm. 2008; 5(3):353-60. DOI: 10.1016/j.hrthm.2007.11.006. View

14.

Metzner A, Wissner E, Lin T, Ouyang F, Kuck K . Balloon Devices for Atrial Fibrillation Therapy. Arrhythm Electrophysiol Rev. 2016; 4(1):58-61. PMC: 4711574. DOI: 10.15420/aer.2015.4.1.58. View

15.

Nagashima K, Okumura Y, Watanabe I, Nakahara S, Hori Y, Iso K . Hot Balloon Versus Cryoballoon Ablation for Atrial Fibrillation: Lesion Characteristics and Middle-Term Outcomes. Circ Arrhythm Electrophysiol. 2018; 11(5):e005861. DOI: 10.1161/CIRCEP.117.005861. View

16.

Nakahara S, Hori Y, Fukuda R, Nishiyama N, Kobayashi S, Sakai Y . Characterization of Residual Conduction Gaps After HotBalloon-Based Antral Ablation of Atrial Fibrillation　- Evidence From Ultra-High-Resolution 3-Dimensional Mapping. Circ J. 2019; 83(6):1206-1213. DOI: 10.1253/circj.CJ-18-1051. View

17.

Heeger C, Rexha E, Maack S, Rottner L, Fink T, Mathew S . Reconduction After Second-Generation Cryoballoon-Based Pulmonary Vein Isolation　- Impact of Different Ablation Strategies. Circ J. 2020; 84(6):902-910. DOI: 10.1253/circj.CJ-19-1144. View

18.

Heeger C, Wissner E, Mathew S, Deiss S, Lemes C, Rillig A . Once Isolated, Always Isolated? Incidence and Characteristics of Pulmonary Vein Reconduction After Second-Generation Cryoballoon-Based Pulmonary Vein Isolation. Circ Arrhythm Electrophysiol. 2015; 8(5):1088-94. DOI: 10.1161/CIRCEP.115.003007. View

19.

Evonich R, Nori D, Haines D . Efficacy of pulmonary vein isolation with a novel hot balloon ablation catheter. J Interv Card Electrophysiol. 2012; 34(1):29-36. DOI: 10.1007/s10840-011-9646-1. View