ABSTRACT
Introduction: The clinical efficacy and safety of hot balloon
ablation (HBA) for treatment of persistent AF (PerAF) remain unclear. We
aimed to evaluate the clinical efficacy and safety of HBA vs.
cryoballoon ablation (CBA) as treatment for PerAF.
Methods: Of 195 consecutive patients who underwent initial
catheter ablation for PerAF (AF lasting >7 days but
<12 months), 158 propensity score-matched (79 HBA and 79 CBA)
patients were included in our study. All patients who underwent HBA
received applications of energy to the upper posterior LA wall with a
larger balloon in addition to single shots to each pulmonary vein (PV)
ostium, whereas those who underwent CBA received simple single-shot
applications. The electrically isolated surface area (ISA), including
the PV antrum and part of the posterior LA wall, was assessed by
high-resolution mapping.
Results: Success of the PV isolation with balloon shots alone
did not differ between HBA and CBA (81% vs. 85%; P = 0.52). The
ISA was generally wide in both groups and significantly larger in the
HBA group than in the CBA group (61 ± 16% vs. 51 ± 12%, P< 0.001). The incidence of procedure-related complications did
not differ significantly (HBA 4% vs. CBA 1%; P = 0.62) nor did
the arrhythmia recurrence rate (HBA 11% vs. CBA 18% at 18 months;P = 0.26).
Conclusion : Despite the difference in protocols, HBA and CBA
performed for PerAF appear comparable in terms of wide antral lesion
creation, clinical efficacy, and safety.