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Comparison between cryoballoon and hot balloon ablation in patients with paroxysmal atrial fibrillation

Journal of Interventional Cardiac Electrophysiology (2021)Cite this article

Abstract

Purpose

Pulmonary vein (PV) isolation using balloon ablation was developed as a technique for patients with paroxysmal atrial fibrillation (PAF). While most studies examined cryoballoon ablation (CBA), there have also been many reports on hot balloon ablation (HBA). We aimed to evaluate the clinical characteristics and outcomes between HBA and CBA.

Methods

In a total of 103 consecutive patients with PAF who underwent catheter ablation, 60 propensity score–matched (30 CBA and 30 HBA) patients were enrolled. The procedural differences and clinical outcomes between the two groups were analyzed.

Results

The requirement for additional touch-up ablation was more frequent in the left superior pulmonary vein (LSP) in the HBA group than in the CBA group. Pre-procedural computed tomography (CT) images showed that a thicker left pulmonary vein ridge and larger cross-sectional area of the LSPV were significantly associated with residual PV potentials after HBA. However, post-procedural CT images showed that PV stenosis (> 25%) was higher in the HBA group (33%) than in the CBA group (0%). PV stenosis after HBA was observed most frequently in the right superior PV (50%). The atrial fibrillation/atrial tachycardia–free survival rate during follow-up (365 ± 102 days) was similar between the two groups (CBA vs. HBA, 83% vs. 90%).

Conclusions

Although both balloon modalities can relieve atrial arrhythmia after the procedure, careful attention is required during HBA procedures, especially for the right superior PV, to avoid PV stenosis.

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Acknowledgements

We thank Edanz Group Japan (https://en-author-services.edanzgroup.com/ac) for editing a draft of this manuscript.

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Affiliations

  1. Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan

    Kazuki Suruga, Kazuyoshi Suenari, Takayuki Nakano, Hajime Takemoto, Yuu Hashimoto, Shunsuke Tomomoi, Tadanao Higaki, Kazuoki Dai, Kuniomi Oi, Tomoharu Kawase, Yasuharu Nakama, Kenji Nishioka, Masaya Otsuka, Yoshiko Masaoka & Nobuo Shiode

  2. Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan

    Kazuki Suruga & Hiroshi Ito

Authors
  1. Kazuki Suruga
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  2. Kazuyoshi Suenari
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  3. Takayuki Nakano
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  4. Hajime Takemoto
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  5. Yuu Hashimoto
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  6. Shunsuke Tomomoi
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  8. Kazuoki Dai
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  9. Kuniomi Oi
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  10. Tomoharu Kawase
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  11. Yasuharu Nakama
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  12. Kenji Nishioka
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  13. Masaya Otsuka
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  14. Yoshiko Masaoka
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  15. Nobuo Shiode
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  16. Hiroshi Ito
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Contributions

All authors have made substantial contributions to the acquisition, analysis, or interpretation of data. The first draft of the manuscript was written by KS (Kazuki Suruga). KS (Kazuyoshi Suenari) conceived of the study and participated in its design and coordination and helped to draft the manuscript. NS and HI commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kazuyoshi Suenari.

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Ethics approval

The study was approved by the Hiroshima City Hiroshima Citizens Hospital. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Suruga, K., Suenari, K., Nakano, T. et al. Comparison between cryoballoon and hot balloon ablation in patients with paroxysmal atrial fibrillation. J Interv Card Electrophysiol (2021). https://doi.org/10.1007/s10840-021-00978-0

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  • DOI: https://doi.org/10.1007/s10840-021-00978-0

Keywords

  • Pulmonary vein
  • Catheter ablation
  • Paroxysmal atrial fibrillation
  • Cryoballoon ablation
  • Hot balloon ablation