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Early experience with a new multi-electrode radiofrequency balloon using integrated 3D imaging for pulmonary vein isolation in atrial fibrillation
Session:
Sessão de Posters 13 - Ablação de fibrilhação auricular
Speaker:
Mário Martins Oliveira
Congress:
CPC 2024
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Mário Martins Oliveira; Silvia Ribeiro; Afonso Ferreira; Sofia Jacinto; Guilherme Portugal; Bruno Valente; Pedro Silva Cunha; Ana Sofia Delgado; Nuno Cortez Dias; João Sousa; Victor Sanfins
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="background-color:white"><span style="color:black">Catheter ablation has become an important treatment for patients with symptomatic atrial fibrillation (AF), with pulmonary vein isolation (PVI) showing more success than medical therapy, and being accepted as the cornerstone of AF ablation. Single-shot technologies have emerged as a common option for AF ablation, providing a more simplified approach targeting only PVI. However, these procedures are fluoroscopy-based. </span></span>Recently, a radiofrequency (RF) balloon ablation system (<em><span style="font-size:10.0pt">Heliostar™, Biosense Webster</span></em>), combining single-shot PVI with an integrated 3D electroanatomic mapping system, showed favourable safety and clinical outcomes. This preliminary study aimed to assess the initial experience with this innovative technology regarding feasibility and safety in AF ablation. <strong>Methods: </strong>We studied the first consecutive patients (learning curve) with paroxysmal (PAF) or persistent AF undergoing “de novo” PVI, using the Heliostar RF balloon in three centers experienced in cryoballoon AF ablation. Clinical characteristics, procedural data, safety and early AF recurrence were analyzed. <strong>Results: </strong>There were 17 patients (59% male, mean age 62±10 years, 65% PAF, left ventricular ejection fraction 30-63%), all medicated with a beta-blocker and/or an anti-arrhythmic drug. Mean left atrium volume was 40±12 ml/m2. Regarding procedural characteristics: general anaesthesia – 70%, deep sedation – 30%, oesophagus thermometer – 100%, pre- and post-PVI 3D mapping – 100%, mean “skin-to-skin” time - 87±35 min, fluoroscopy time - 11±8 min, and RF time - 7.0±0.5 min. The total number of RF applications was 6±1/per patient. In 8 cases (47%), PVI was obtained with a single shot in all veins. Mean time-to-isolation was 9 sec for the left superior pulmonary vein, 10.3 sec for the left inferior, 8 sec for the right superior and 9 sec for the right inferior. In 2 cases, RF application was interrupted due to increased oesophageal temperature (>2<sup>o</sup> C). No acute complications were registered during the procedure. During a median 4-month follow-up, 6 patients (35%) exhibited AF episodes, all but one during during the blanking period. No complications were observed during this period. <strong>Conclusion:</strong> Our early learning curve experience shows that single-shot PVI using the novelle Heliostar technology appears to be a safe and effective option for AF ablation, with favourable procedural duration, fluoroscopy time and RF time. Longer follow-up and larger experience are necessary to establish the role of this approach in daily clinical practice.</span></span></p> <p> </p>
Slides
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