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Efficacy of pulmonary vein isolation with a novel hot balloon ablation catheter

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Due to the variable anatomy of the human pulmonary vein (PV), PV isolation for atrial fibrillation ablation is challenging. A novel hot balloon ablation catheter has been developed to improve ablation outcomes. The efficacy, histopathologic lesion characteristics, and thermodynamics of this technology were examined.

Methods

Swine underwent left atrial (n = 24) and superior vena cava (SVC, n = 7) catheterization with a compliant balloon catheter filled with saline and contrast. After PV mapping and angiography, ablation was performed with radiofrequency energy heating of the balloon contents. Central balloon temperatures were varied from 60°C to 90°C, and durations of energy delivery were varied from 60 to 300 s. Endocardial and epicardial temperatures were recorded contiguous to the balloon during SVC ablations. Pathology was examined.

Results

With a mean of 1.4 ± 0.9 ablations per PV at 70°C, 93% were electrically isolated. Necropsy exam revealed extraostial lesions without charring. PVs ablated at temperatures ≥80°C and durations ≥180 s were associated with a high rate of successful isolation with a single ablation. Higher-temperature lesions displayed greater histopathologic uniformity, but more marked fibrin deposition. Chronic lesions revealed granulation tissue and fibrosis. No thromboembolic events were observed and histopathology of the phrenic nerve and esophagus was normal in all specimens.

Conclusions

The hot balloon ablation catheter appears to be a safe and effective tool for PV isolation. Higher temperatures and longer ablation durations are associated with a higher single ablation success rate.

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Funding sources

The study was supported by a grant from Toray Industries Inc. and by the Frances and Dominic Moceri Fund for Heart Rhythm Research

Disclosures

Dr. Haines has received grant funding from Toray Industries Inc.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA

    Rudolph F. Evonich, David M. Nori & David E. Haines

  2. Heart Rhythm Center, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, MI, 48073, USA

    David E. Haines

Authors
  1. Rudolph F. Evonich
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  2. David M. Nori
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  3. David E. Haines
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Correspondence to David E. Haines.

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Evonich, R.F., Nori, D.M. & Haines, D.E. Efficacy of pulmonary vein isolation with a novel hot balloon ablation catheter. J Interv Card Electrophysiol 34, 29–36 (2012). https://doi.org/10.1007/s10840-011-9646-1

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  • DOI: https://doi.org/10.1007/s10840-011-9646-1

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