Abstract 905 Pulmonary vein isolation with a novel radiofrequency balloon catheter: real-world predictors of single shot isolation

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Pulmonary vein isolation with a novel radiofrequency balloon catheter: real-world predictors of single shot isolation
I. My¹, S. Bordignon², M. Butt¹, L. Rottner³, F. Moser³, J. Wenzel³, J. Obergassel³, R. Schleberger⁴, J. Moser⁴, L. Dinshaw⁵, P. Kirchhof³, B. Reißmann⁶, F. Ouyang³, K. R. J. Chun⁷, B. Schmidt⁸, A. Rillig⁴, A. Metzner⁴
¹Elektrophysiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; ²Medizinisches Versorgungszentrum, CCB am AGAPLESION BETHANIEN KRANKENHAUS, Frankfurt am Main; ³Klinik für Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; ⁴Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; ⁵Klinik für Kardiologie, Sana Hanse-Klinikum Wismar GmbH, Wismar; ⁶Allgemeine und Interventionelle Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; ⁷Medizinische Klinik III - CCB, Agaplesion Markus Krankenhaus, Frankfurt am Main; ⁸Agaplesion Markus Krankenhaus, Frankfurt am Main;
Background: A novel multi-electrode radiofrequency balloon (RFB) catheter (HELIOSTAR, Biosense Webster) has been released for pulmonary vein isolation (PVI). Objectives: First multicenter real-world study to evaluate predictors of single shot PVI with the novel RFB catheter. Methods: In this observational study consecutive patients with drug refractory paroxysmal or persistent atrial fibrillation (AF) undergoing first-time PVI were enrolled in two high-volume tertiary ablation centers. All procedures were conducted in conjunction with a 3D-mapping system. Clinical, procedural and ablation parameters were systematically analyzed. Results: 105 patients (58% males; 52% paroxysmal AF) were included. Mean left atrial volume index was 38.6 ± 14.8 ml/m2. Successful PVI was obtained in 408/412 (99%) PVs, single-shot (SS) PVI in 58.5% with a time to isolation of 11.6 ± 8 s. Total number of applications was 892 and mean number of applications/PV was 2.2. Mean electrodes’ impedance drop was significantly higher in the SS-PVI compared to the non-SS applications (21.5 ± 6.6 vs. 18.6 ± 6.5 Ohm). Concordantly, higher temperature rise was observed in the SS versus non-SS applications (10.9 ± 4.9°C vs. 9.6 ± 4.7°C). Conclusion: In this multicenter real-world study, mean impedance drop and temperature rise emerged as valid predictors for SS-PVI using the novel RFB catheter.
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