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- Title
Posterior wall isolation via a multi-electrode radiofrequency balloon catheter: feasibility, technical considerations, endoscopic findings and comparison with cryoballoon technologies.
- Authors
Del Monte, Alvise; Chierchia, Gian Battista; Della Rocca, Domenico Giovanni; Pannone, Luigi; Sorgente, Antonio; Bala, Gezim; Monaco, Cinzia; Mouram, Sahar; Capulzini Cremonini, Lucio; Audiat, Charles; Praet, Joke; Ramak, Robbert; Overeinder, Ingrid; Ströker, Erwin; Sieira, Juan; La Meir, Mark; Brugada, Pedro; Sarkozy, Andrea; de Asmundis, Carlo; Almorad, Alexandre
- Abstract
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™ (Biosense Webster, CA, USA). Methods: We prospectively enrolled 32 consecutive patients with persistent AF scheduled for first-time ablation with the Heliostar™ 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 ± 72 s versus 1274 ± 277 s 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.
- Subjects
ATRIAL flutter; RADIO frequency; ATRIAL fibrillation; PULMONARY veins; CATHETERS
- Publication
Journal of Interventional Cardiac Electrophysiology, 2024, Vol 67, Issue 2, p273
- ISSN
1383-875X
- Publication type
Article
- DOI
10.1007/s10840-023-01549-1