Usefulness of a New Radiofrequency Thermal Balloon Catheter for Pulmonary Vein Isolation

• Published in: Journal of cardiovascular electrophysiology Vol. 14; no. 6; pp. 609 - 615
• Main Authors: Satake, Shutaro, Tanaka, Kazushi, Saito, Shigeru, Tanaka, Shinji, Sohara, HiroshI, Hiroe, Yoshitaka, Miyashita, Yusuke, Takahashi, Saeko, Murakami, Masato, Watanabe, Yoshio
• Format: Journal Article
• Language: English
• Published: 350 Main Street , Malden , MA 02148 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK Blackwell Science Inc 01-06-2003
• Subjects: atrial fibrillation; balloon catheter; catheter ablation; pulmonary vein; radiofrequency current
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1046/j.1540-8167.2003.02577.x

Introduction: 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).
Methods and 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° to 75°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.
Conclusion: 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. (J Cardiovasc Electrophysiol, Vol. 14, pp. 609‐615, June 2003)