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

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.