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

Journal of Interventional Cardiac Electrophysiology (2020)Cite this article

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.

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Acknowledgments

We thank Ellen Knapp, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

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Affiliations

  1. Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    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

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  1. Hiro Yamasaki
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  2. Kazutaka Aonuma
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  3. Yasutoshi Shinoda
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  5. Hiroaki Watanabe
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Corresponding author

Correspondence to Hiro Yamasaki.

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Conflict of interest

Dr. Yamasaki received a consultant fee from Toray Industries, Inc. and Dr. Aonuma belongs to the endowed Department of Toray Industries, Inc. Dr. Nogami and Dr. Igarashi belong to the endowed Department of Medtronic Japan. Dr. Sekiguchi belongs to the endowed Department of Abbott Japan.

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Tsukuba Clinical Research & Development Organization (H29-307).

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Yamasaki, H., Aonuma, K., Shinoda, Y. et al. Lesion durability after antral pulmonary vein isolation using a radiofrequency hot balloon catheter. J Interv Card Electrophysiol (2020). https://doi.org/10.1007/s10840-020-00857-0

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Keywords

  • Antral pulmonary vein isolation
  • Atrial fibrillation
  • Durability
  • Radiofrequency hot balloon ablation
  • Reconnection site