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- Title
Workflow and predictors of single-shot pulmonary vein isolation using the multielectrode radiofrequency balloon catheter: a subanalysis of the SHINE multicenter study.
- Authors
Grimaldi, Massimo; Quadrini, Federico; Tondo, Claudio; Riva, Stefania; Schilling, Richard; Dhillon, Gurpreet; Reddy, Vivek Y.; Neuzil, Petr; Chierchia, Gian-Battista; de Asmundis, Carlo; Ghaly, Nader; Xiangming Zhang; Adawi, Eid; Kaneko, Christina S.; Yew Ding, Wern; Gupta, Dhiraj
- Abstract
Objective: Safety and effectiveness of the compliant multielectrode radiofrequency balloon catheter (RFB) in paroxysmal atrial fibrillation ablation have been demonstrated in recent multicenter clinical trials. This study aimed to identify factors enabling efficient workflow and predictors of single-shot pulmonary vein isolation (PVI). Methods: This subanalysis evaluated acute data from participants undergoing first-time PVI with the RFB in the multicenter SHINE study. Workflow efficiency analysis compared procedural data for right inferior pulmonary veins (RIPVs) versus other pulmonary veins (PVs) and the effects of learning curves on procedure, fluoroscopy, and balloon dwell times. Ten preablation impedance and temperature parameters of the active electrodes were analyzed for predictors of single-shot isolation (SSI). Results: Among 85 patients, acute PVI rate was 100%. RIPV maneuverability time (time from last radiofrequency [RF] termination of preceding vein to first RF ablation on RIPV) was 5.85±4.98 minutes. Mean procedure and balloon dwell times decreased by 76 and 33 minutes, respectively, after the first procedure. SSI rates were 59.4%-84.3% among the different PVs. Six SSI predictors were identified: maximum (<31°C) and variation (<3°C) of initial temperature on active electrodes; maximum (<110 O), average (<95 O), and variation (<20 O) of initial impedance on active electrodes; all active electrodes with impedance 80-110 O. Conclusion: PVI with the RFB had a short learning curve, with short RIPV maneuverability time and good SSI rates across all PVs. Lower preablation initial temperature and impedance values of active electrodes were important predictors of single-shot PVI and may help guide operator decision before delivering the first RF application.
- Publication
Journal of Atrial Fibrillation & Electrophysiology, 2023, Vol 16, Issue 4, p46
- ISSN
2831-7335
- Publication type
Academic Journal