title: Balloon Devices for Atrial Fibrillation Therapy.
abstract: Ablation of atrial fibrillation (AF) is an established treatment option for symptomatic patients refractory to antiarrhythmic medication. In patients with paroxysmal AF, ablation can be offered as first-line therapy when performed in an experienced centre. The accepted cornerstone for all ablation strategies is isolation of the pulmonary veins. However, it is still challenging to achieve contiguous, transmural, permanent lesions using radio-frequency current (RFC) based catheters in conjunction with a three-dimensional mapping system and the learning curve remains long. These limitations have kindled interest in developing and evaluating novel catheter designs that incorporate alternative energy sources. Novel catheters include balloon-based ablation systems, incorporating different energy modalities such as laser (Heartlight(™), CardioFocus, Marlborough, MA, US), RFC (Hot Balloon Catheter, Hayama Arrhythmia Institute, Kanagawa, Japan) and cryo-energy (ArcticFront, Medtronic, Inc., Minneapolis, MN, US). While the cryoballoon (CB) and the radiofrequency hot balloon (RHB) are single-shot devices, the endoscopic ablation system (EAS) allows for point-by-point ablation. The CB and EAS are well established as safe, time-efficient and effective ablation tools. Initial studies using the RHB could also demonstrate promising results. However, more data are required.
authors.forename: Andreas
authors.initials: A
authors.lastname: Metzner
authors.forename: Erik
authors.initials: E
authors.lastname: Wissner
authors.forename: Tina
authors.initials: T
authors.lastname: Lin
authors.forename: Feifan
authors.initials: F
authors.lastname: Ouyang
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
keywords: Atrial fibrillation; ablation; balloon catheter; cryoballoon; endoscopic ablation system; hot balloon; pulmonary vein isolation
references.citation: J Cardiovasc Electrophysiol. 2014 May;25(5):466-70
references.pmid: 24400647
references.citation: Eur Heart J. 2009 Mar;30(6):699-709
references.pmid: 19109353
references.citation: J Cardiovasc Electrophysiol. 2013 May;24(5):492-7
references.pmid: 23398599
references.citation: Europace. 2013 Aug;15(8):1143-9
references.pmid: 23419659
references.citation: J Cardiovasc Electrophysiol. 2012 Aug;23(8):814-9
references.pmid: 22487260
references.citation: J Am Coll Cardiol. 2001 Dec;38(7):2079-86
references.pmid: 11738318
references.citation: J Cardiovasc Electrophysiol. 2014 Jul;25(7):686-92
references.pmid: 24576252
references.citation: Am Heart J. 2012 Jul;164(1):1-6.e6
references.pmid: 22795275
references.citation: Heart Rhythm. 2011 Jun;8(6):815-20
references.pmid: 21236365
references.citation: J Am Coll Cardiol. 2013 Apr 23;61(16):1713-23
references.pmid: 23500312
references.citation: Heart Rhythm. 2013 Sep;10(9):1318-24
references.pmid: 23891574
references.citation: J Cardiovasc Electrophysiol. 2013 Jan;24(1):7-13
references.pmid: 22966825
references.citation: Circ Arrhythm Electrophysiol. 2013 Aug;6(4):769-75
references.pmid: 23748208
references.citation: J Cardiovasc Electrophysiol. 2012 Nov;23 (11):1254-7
references.pmid: 22486804
references.citation: J Cardiovasc Electrophysiol. 2010 Aug 1;21(8):869-74
references.pmid: 20233270
references.citation: Europace. 2013 May;15(5):685-9
references.pmid: 23129544
references.citation: Heart Rhythm. 2009 Jul;6(7):962-9
references.pmid: 19560085
references.citation: Heart Rhythm. 2013 Jun;10(6):789-93
references.pmid: 23428962
references.citation: Circ Arrhythm Electrophysiol. 2009 Jun;2(3):225-32
references.pmid: 19808472
references.citation: Heart Rhythm. 2012 Jun;9(6):919-25
references.pmid: 22293143
references.citation: Europace. 2014 Feb;16(2):214-9
references.pmid: 23933850
references.citation: Circulation. 2010 Dec 7;122(23):2368-77
references.pmid: 21098450
references.citation: Europace. 2014 Dec;16(12):1746-51
references.pmid: 25031237
references.citation: Circ Arrhythm Electrophysiol. 2010 Oct;3(5):481-8
references.pmid: 20657031
references.citation: Heart Rhythm. 2012 Sep;9(9):1380-5
references.pmid: 22472520
references.citation: Circ Arrhythm Electrophysiol. 2013 Jun;6(3):467-72
references.pmid: 23559674
references.citation: J Cardiovasc Electrophysiol. 2014 Aug;25(8):845-51
references.pmid: 24678900
references.citation: Circulation. 2009 Jul 7;120(1):12-20
references.pmid: 19546385
references.citation: Eur Heart J. 2012 Nov;33(21):2719-47
references.pmid: 22922413
references.citation: J Interv Card Electrophysiol. 2014 Mar;39(2):145-51
references.pmid: 24317917
references.citation: Heart Rhythm. 2011 Sep;8(9):1444-51
references.pmid: 21457789
references.citation: J Am Coll Cardiol. 2013 Apr 23;61(16):1707-12
references.pmid: 23199518
references.citation: Heart Rhythm. 2010;7(2):184-90
references.pmid: 20129295
references.citation: Circ Arrhythm Electrophysiol. 2014 Apr;7(2):288-92
references.pmid: 24610797