Acute efficacy and clinical outcomes using HotBalloon for pulmonary vein isolation in patients with a left common pulmonary vein

摘要

Abstract Introduction HotBalloon material is compliant and the balloon size can be enlarged by increasing the intraballoon injection volume. HotBalloon‐based pulmonary vein isolation (PVI) has demonstrated encouraging clinical results in the treatment of paroxysmal atrial fibrillation (PAF), however, the acute efficacy and clinical outcomes of the HotBalloon‐based PVI have never been fully investigated in patients with a left common pulmonary vein (LCPV). Methods and Results One hundred fifty‐three PAF patients underwent HotBalloon‐based PVI. Three‐dimensional computed tomography was performed in all patients before the ablation. An LCPV was observed in 40 (26%) patients. For HotBalloon ablation of an LCPV, in patients with an LCPV of superoinferior diameter 34?mm, the left common ostium was preferably isolated if sufficient occlusion could be achieved. In patients with an LCPV diameter ≥34?mm, left superior and inferior branches of the LCPV were targeted individually. The number of HotBalloon applications in patients with LCPV was significantly smaller than without LCPV (7.3?±?2.0 vs 8.1?±?2.1; P ?=?.04). In patients with LCPV diameter 34?mm, 75% of LCPVs successfully achieved full balloon occlusion (50% were isolated by application at the LCPV ostium alone, 25% by application at the LCPV ostium followed by either superior or inferior LCPV branch ablation) and 25% were isolated individually. One year after a single session, the arrhythmia‐free rates were similar between patients with and without LCPV (77% vs 74%, log rank, P ?=?.86). Conclusions HotBalloon‐based PVI delivers long‐term favorable success rates with fewer HotBalloon applications in paroxysmal AF patients with an LCPV.