Pulmonary vein isolation with the radiofrequency balloon catheter: a single centre prospective study

Abstract

Aims The multielectrode radiofrequency balloon catheter (RFB) has been developed to achieve safe and effective pulmonary vein isolation (PVI) for atrial fibrillation (AF) ablation. This single-centre study aimed to evaluate the midterm clinical outcome and predictors of single-shot PVI with the novel RFB. Methods and results All consecutive patients with symptomatic paroxysmal or persistent AF undergoing first-time PVI with the RFB were prospectively included. Clinical and procedural parameters were systematically collected. The primary safety endpoint was defined as any major periprocedural complications. The primary efficacy endpoint consisted of freedom from any atrial tachyarrhythmias (ATas) lasting >30 s during the follow-up after a 3-month blanking period. Persistent single-shot PVI was defined as PVI achieved with a single RFB application without acute reconnection. A total of 104 consecutive patients (mean age 64.3 ± 11.4 years, 56.7% males) were included. 15 patients (14.4%) presented with persistent AF. The procedure time was 59.0 min with a dwell time of 20.0 min. One major complication occurred in one patient. At a mean follow-up of 10.1 ± 5.3 months, freedom from ATas was 82.9%. ATas occurred in 14 patients, 11/69 patients (15.9%) with paroxysmal AF and 3/13 (23.1%) with persistent AF. The best cut-offs to predict persistent single-shot PVI were impedance drop >19.2 Ω [area under the receiver operator characteristic curve (AUC) 0.74] and temperature rise >11.1° C (AUC 0.77). Conclusion In a large cohort of patients undergoing PVI with the RFB, the complication rate was 1%. At a mid-term follow-up of 10.1 ± 5.3 months, freedom from ATas was 82.9%. Specific cut-offs of impedance drop and temperature rise may be useful to predict persistent single-shot isolation.

Definition and management of arrhythmia-induced cardiomyopathy: findings from the European Heart Rhythm Association survey

“…The consensus on antiarrhythmic treatment strategies, particularly the widespread use of CA, 23 , 24 suggests a strong preference for rhythm control in AiCM, aligning with recent data 19 , 25–28 and current guidelines recommending CA as a first-line treatment when AiCM is highly probable independent of symptom status (class I, level of evidence B, ESC Guidelines). 29 , 30…”

Interest of thoracic ultrasound after cardiac surgery or interventional cardiology

“…The incidence of persistent diaphragm paralysis was 0.7%, the risk being increased in womens. In a recent prospective, multicenter study conducted in 375 subjects comparing cryoballoon to radiofrequency, data showed that cryoablation has the highest level of phrenic nerve injury with 7.20% transient paralysis compared to 3.20% for radiofrequency[ 21 ]. Today, a new non-thermal energy modality, called pulse field ablation (PFA) therapy has emerged.…”

Transcatheter options for atrial fibrillation treatment: an overview of the ablative techniques currently available and future perspectives

“…It is generated at a frequency of 500–1,000 KHz and transmitted between the catheter tip and a skin patch. Even if RF single-shot catheters are currently available ( 29 ), RF is mostly delivered with a point-by-point approach. However, this technique is demanding and associated with a long learning curve.…”