Posterior wall isolation via a multi-electrode radiofrequency balloon catheter:feasibility, technical considerations, endoscopic findings, and comparison with cryoballoon technologies

Research output: Unpublished contribution to conferencePoster

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 ablation, PW isolation can be also achieved with different cryoballoon (CB) technologies.
Objective
To assess the feasibility of PW isolation with the novel RF balloon catheter and perform a comparison with CB technologies.
Methods
• We prospectively enrolled 35 consecutive patients with persistent AF scheduled for first-time ablation with the RF balloon device.
• Procedural data were compared with those from 100 persistent AF patients undergoing pulmonary vein (PV) plus PW isolation with a CB device. The ratio RF balloon/CB was 1:3 for each operator involved.
• Primary safety endpoint was defined as the incidence of any serious procedure-related adverse events (death, atrioesophageal or pericardial-oesophageal fistula, stroke/TIA, myocardial infarction, phrenic nerve palsy, serious vascular complications).
• Primary efficacy endpoint was defined as successful PW isolation after PVI, defined as electrical silence and bidirectional block at post-ablation 3D mapping.
Results
• Single-shot PV isolation was achieved in a significantly higher number of cases with the RF balloon compared to CB (89.8% vs 81.0%; p=0.02).
• PW isolation was achieved with a similar number of balloon applications (11±4 with the RF balloon versus 11±2 with the CB; p=0.16) but a significantly shorter time among RF balloon patients (225±83s versus 1273±280s with CB; p<0.001).
• Primary safety endpoint occurred in none of RF balloon patients versus 8 (8%; 6 transient phrenic nerve palsies, 1 groin hematoma, 1 femoral pseudoaneurysm) patients in the CB group (p=0.11).
• Primary efficacy endpoint was achieved in all (100%) RF balloon patients versus 95 (95%) CB ones (p=0.57).
• Oesophageal endoscopy did not show any signs of thermal lesions in the RF balloon patients with luminal temperature rise (T>41°C).
Conclusions
RF balloon-based PW isolation was safe and promoted shorter procedural times compared to similar CB-based ablation procedures.
Original languageEnglish
Publication statusUnpublished - 2023
EventHRS 2023 - New Orleans, New Orleans, United States
Duration: 19 May 202321 May 2023

Conference

ConferenceHRS 2023
Country/TerritoryUnited States
CityNew Orleans
Period19/05/2321/05/23

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