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Hot balloon versus cryoballoon ablation for persistent atrial fibrillation: Lesion area, efficacy, and safety
Author(s) -
Wakamatsu Yuji,
Nakahara Shiro,
Nagashima Koichi,
Fukuda Reiko,
Nishiyama Naoki,
Watanabe Ryuta,
Arai Masaru,
Otsuka Naoto,
Kurokawa Sayaka,
Sato Hirotsugu,
Ishikawa Tetsuya,
Hori Yuichi,
Okumura Yasuo,
Taguchi Isao
Publication year - 2020
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.14646
Subject(s) - medicine , pulmonary vein , ablation , balloon , atrial fibrillation , ostium , catheter ablation , surgery , balloon catheter , cardiology , lesion
The clinical efficacy and safety of hot balloon ablation (HBA) for the treatment of persistent AF (PerAF) remain unclear. We aimed to evaluate the clinical efficacy and safety of HBA versus cryoballoon ablation (CBA) as a treatment for PerAF. Methods Of 195 consecutive patients who underwent initial catheter ablation for PerAF (AF lasting for longer than 7 days but shorter than 12 months), 158 propensity score‐matched (79 HBA and 79 CBA) patients were included in our retrospective study. All patients who underwent HBA received applications of energy to the upper posterior LA wall with a larger balloon in addition to single shots to each pulmonary vein (PV) ostium, whereas those who underwent CBA received simple single‐shot applications. The electrically isolated surface area (ISA), including the PV antrum and part of the posterior LA wall, was assessed by high‐resolution mapping. Results The success of the PV isolation with balloon shots alone did not differ between HBA and CBA (81% vs. 85%; p = .52). The ISA was generally wide in both groups and significantly larger in the HBA group than in the CBA group (61 ± 16% vs. 51 ± 12%; p < .001). The incidence of procedure‐related complications did not differ significantly (HBA 4% vs. CBA 1%; p = .62) nor did the arrhythmia recurrence rate (HBA 11% vs. CBA 18% at 18 months; p = .26). Conclusion Despite the difference in protocols, HBA and CBA performed for PerAF appear comparable in terms of wide antral lesion creation, clinical efficacy, and safety. Further prospective studies, based on a unified methodology, are needed.