Background: Posterior wall (PW) isolation is an important adjunctive ablation target in patients with non-paroxysmal atrial fibrillation (AF). Traditionally performed with point-by-point radiofrequency (RF) ablation, PW isolation has also been performed with different cryoballoon technologies.We aimed at assessing the feasibility of PW isolation with the novel RF balloon catheter Heliostar TM (Biosense Webster, CA, USA). Methods:We prospectively enrolled 32 consecutive patients with persistent AF scheduled for firsttime ablation with the Heliostar TM device. Procedural data were compared with those from 96 consecutive persistent AF patients undergoing pulmonary vein (PV) plus PW isolation with a cryoballoon device. The ratio RF balloon/cryoballoon was 1:3 for each operator involved in the study, aiming at avoiding any imbalance related to different experience.Results: Single-shot PV isolation was documented in a significantly higher number of cases with the RF balloon technology compared to cryoballoon ablation (89.8% vs 81.0%; p=0.02, respectively).PW isolation was achieved with a similar number of balloon applications between the two groups (11±4 with the RF balloon versus 11±2 with the cryoballoon; p=0.16), but in a significantly shorter time among RF balloon patients (228±72s versus 1274±277s with cryoballoon; p<0.001). Primary safety endpoint occurred in none of the RF balloon patients versus 5 (5.2%) patients in the cryoballoon group (p=0.33). Primary efficacy endpoint was achieved in all (100%) RF balloon patients versus 93 (96.9%) cryoballoon ones (p=0.57). Oesophageal endoscopy did not show any signs of thermal lesions in RF balloon patients with luminal temperature rise.Conclusions: RF balloon-based PW isolation was safe and promoted shorter procedure times compared to similar cryoballoon-based ablation procedures.

No abstract

No abstract