title: Usefulness of a new radiofrequency thermal balloon catheter for pulmonary vein isolation: a new device for treatment of atrial fibrillation.
abstract: 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.
authors.affiliation: Cardiology and Catheterization Laboratories, Heart Center, Shonan Kamakura General Hospital, Kamakura, Japan. satake@kamakuraheart.org
authors.forename: Shutaro
authors.initials: S
authors.lastname: Satake
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sohara
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Hiroe
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Miyashita
authors.forename: Saeko
authors.initials: S
authors.lastname: Takahashi
authors.forename: Masato
authors.initials: M
authors.lastname: Murakami
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Watanabe
mesh_terms: 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
chemical_list: D000889:Anti-Arrhythmia Agents