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Long‐Term Results of Radiofrequency Hot Balloon Ablation in Patients With Paroxysmal Atrial Fibrillation: Safety and Rhythm Outcomes
Author(s) -
YAMAGUCHI YOSHIO,
SOHARA HIROSHI,
TAKEDA HIROSHI,
NAKAMURA YOSHINORI,
IHARA MINORU,
HIGUCHI SATOSHI,
SATAKE SHUTARO
Publication year - 2015
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12820
Subject(s) - medicine , atrial fibrillation , cardiology , ablation , ejection fraction , balloon , catheter ablation , stenosis , surgery , heart failure
Long‐Term Outcomes Following Hot Balloon Ablation Introduction Isolation of pulmonary veins (PVs) and the posterior left atrium (LA) can be safely performed by radiofrequency hot balloon (RHB)‐based box isolation. However, data on long‐term effects for the treatment of atrial fibrillation (AF) by the use of this method remain limited. Methods and Results We treated 238 patients with paroxysmal AF (194 male; age. 62.6 ± 9.4 years) by RHB ablation. During 6.2‐year (75 months) follow‐up, 154 (64.7%) patients were free from atrial tachyarrhythmias (ATAs) without antiarrhythmic‐drugs (AADs). We performed re‐ablation in 69 of 84 patients with ATA recurrence (average 1.3 ± 0.6; median 1, total 91 procedures) using a 3D‐mapping system and a conventional catheter. The sites of reconnection were observed at the PV in 61 of 69 (88.4%) patients and at the posterior LA in 58 of 69 (84.1%) patients. Finally, during mean follow‐up of 4.6 ± 1.6 years, no‐ATA episodes were detected in 201 (84.5%) patients without AADs. Independent predictors of ATA recurrence following a single procedure were heart failure with preserved ejection fraction (HR: 2.67, 95%CI: 1.40–5.10, P = 0.003) and low estimated glomerular filtration rate (HR: 1.81, 95%CI: 1.11–2.93, P = 0.03; cut‐off of 62.0 mL/min/1.73 m 2 ). During the follow‐up period, there were 4 (1.7%) patients with PV stenosis (>70% reduction in PV diameter); however, none of these cases required intervention. Phrenic nerve palsy was detected in 8 patients (3.4%), but resolved during 3 months in all cases. Conclusion RHB ablation can be effective during a long‐term follow‐up for patients with paroxysmal AF. Safety outcomes were within an acceptable range.