Pulmonary vein isolation with a novel radiofrequency balloon catheter: real-world predictors of single shot isolation

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background A novel multi-electrode radiofrequency balloon (RFB) catheter has been released for pulmonary vein isolation (PVI). Objectives First multicenter real-world study to evaluate predictors of single shot PVI with the novel RFB catheter. Methods In this observational study consecutive patients with drug refractory paroxysmal or persistent atrial fibrillation (AF) undergoing first-time PVI were enrolled in two high-volume ablation centers. All procedures were conducted in conjunction with a 3D-mapping system. Clinical, procedural and ablation parameters were systematically analyzed. Results 105 patients (58% males; 52% paroxysmal AF, 68 ± 11.3 mean age, left atrial volume index 38.6 ± 14.8 ml/m2) were included. 241/412 (58.5%) pulmonary veins were successfully isolated with a single shot (SS), with a time to isolation of 11.6 ± 8 s. Total number of radio frequency applications was 892 (mean 2.2/PV), resulting in successful isolation of 408/412 (99%) PVs at the end of the procedure. Mean electrodes’ impedance drop was significantly higher in the SS-PVI compared to the non-SS applications (21.5 ± 6.6 vs. 18.6 ± 6.5 Ohm). Concordantly, higher temperature rise was observed in the SS versus non-SS applications (10.9 ± 4.9°C vs. 9.6 ± 4.7°C). Conclusion In this multicenter real-world study, mean impedance drop and temperature rise emerged as valid predictors for SS-PVI with the novel RFB catheter. These parameters may help to guide efficient usage of the new RF balloon.