Lesion durability after antral pulmonary vein isolation using a radiofrequency hot balloon catheter
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Lesion durability after antral pulmonary vein isolation using a radiofrequency hot balloon catheter Hiro Yamasaki 1 & Kazutaka Aonuma 1 & Yasutoshi Shinoda 1 & Yuki Komatsu 1 & Hiroaki Watanabe 1 & Akira Kimata 1 & Satoshi Aita 1 & Masayuki Hattori 1 & Takeshi Machino 1 & Miyako Igarashi 1 & Yukio Sekiguchi 1 & Akihiko Nogami 1 & Masaki Ieda 1 Received: 2 June 2020 / Accepted: 24 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
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
1 Introduction High lesion durability after pulmonary vein (PV) isolation plays a critical role in treatment of any type of atrial fibrillation (AF). A cryoballoon (CB) and visually guided laser balloon (VGLB) have high durability in the PV isolation area during follow-up [1, 2]. The radiofrequency hot balloon catheter ((RHB) SATAKE Hot-Balloon; Toray Industries, Inc., Tokyo, Japan) consists of a high-compliance, size-adjustable balloon (diameter: 25–33 mm) and is an alternative therapeutic option for treating AF regardless of PV anatomy [3]. We
* Hiro Yamasaki [email protected] 1
Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
recently reported initial results of a novel, single-shot technique targeting the PV antrum with a large injection volume [4]. Longer energy application with a larger injection volume enabled creation of a contiguous transmural lesion at the level of the PV antrum. As a result, phrenic nerve injury, which s
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