Usefulness of a new radiofrequency thermal balloon catheter for pulmonary vein isolation: a new device for treatment of atrial fibrillation.
BACKGROUND
A rapidly firing or triggered ectopic focus located within a pulmonary vein (PV) or close to the PV ostium could induce atrial fibrillation (AF). The aim of this study was to evaluate the efficacy and safety of a radiofrequency thermal balloon catheter for isolation of the PV from the left atrium (LA).


RESULTS
Twenty patients with drug-resistant paroxysmal AF were treated by isolating the superior PVs using an RF thermal balloon catheter. Using a transseptal approach, the balloon, which had an inflated diameter 5 to 10 mm larger than that of the PV ostium, was wedged at the LA-PV junction. It was heated by a very-high-frequency current (13.56 MHZ) applied to the coil electrode inside the balloon for 2 to 3 minutes, and the procedure was repeated up to four times. The balloon center temperature was maintained at 60 degrees to 75 degrees C by regulating generator output. Successful PV isolation was achieved in 19 of the 20 left superior PVs and in all 20 of the right superior PVs and was associated with a decrease in amplitude of the ostial potentials. Total procedure time was 1.8 +/- 0.5 hours, which included 22 +/- 7 minutes of fluoroscopy time. After a follow-up period of 8.1 +/- 0.8 months, 17 patients were free from AF, with 10 not taking any antiarrhythmic drugs and 7 taking the same antiarrhythmic agent as before ablation. Electron beam computed tomography revealed no complications, such as PV stenosis at ablation sites.


CONCLUSIONS
The PV and its ostial region can be safely and quickly isolated from the LA by circumferential ablation around the PV ostia using a radiofrequency thermal balloon catheter for treatment of AF.
Satake
Shutaro
S
Cardiology and Catheterization Laboratories, Heart Center, Shonan Kamakura General Hospital, Kamakura, Japan. satake@kamakuraheart.org
Tanaka
Kazushi
K
Saito
Shigeru
S
Tanaka
Shinji
S
Sohara
Hiroshi
H
Hiroe
Yoshitaka
Y
Miyashita
Yusuke
Y
Takahashi
Saeko
S
Murakami
Masato
M
Watanabe
Yoshio
Y
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000628:therapy; D001794:Blood Pressure / Q000502:physiology; D017115:Catheter Ablation; D002404:Catheterization; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D004562:Electrocardiography; D004567:Electrodes, Implanted; D022062:Electrophysiologic Techniques, Cardiac; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D010865:Pilot Projects; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents