Thermal balloon catheters have improved the efficiency of pulmonary vein isolation (PVI) in atrial fibrillation (AF). Reports assessing additional safety and effectiveness of pulsed field ablation (PFA) balloon catheters for PVI are limited. This study aims to assess the safety and effectiveness of a conformal PFA balloon catheter for PVI in paroxysmal AF. 35 patients with paroxysmal AF (PAF) were treated with a PFBalloon catheter (Biphasic, Bipolar, 750 V). The balloon was inflated with 10:1 saline/contrast, with volume adjusted for spherical wide-antral or pear-shaped ostial-junction PV ablation to ensure optimal tissue contact. The primary safety endpoint was absence of periprocedural primary adverse events. The primary effectiveness endpoint was acute PVI. The secondary effectiveness endpoint included durable PVI assessed by remapping at three months post-ablation and 1-year clinical outcomes. All targeted PVs (142/142) in 35 patients were acutely isolated, with 32.3 ± 4.5 applications per patient and 7.9 ± 1.0 per vein. Procedure and left atrial dwell times were 133 ± 46 and 56 ± 25 min, respectively. No hemolysis-related acute kidney injury or severe device-related complications occurred. PVI durability was 76.0
Pulmonary vein isolation (PVI) ablation has limited efficacy in persistent atrial fibrillation (PeAF). Anatomical strategies combining PVI, vein of Marshall ethanol infusion (VOM-EI), and an anatomical ablation strategy (AS) targeting key atrial isthmuses have shown promising short-term outcomes in this setting. In this retrospective multicenter observational cohort study, consecutive patients with PeAF who underwent either VOM-EI + AS or PVI-only were included. The primary endpoint was freedom from atrial arrhythmias (AAs) lasting > 30 s off antiarrhythmic drugs (AADs). Procedural characteristics and safety outcomes were also evaluated. After 2:1 propensity score matching, 151 patients treated with VOM-EI + AS were compared with 75 treated with PVI-only. After a median follow-up of 22-month (interquartile range (IQR): 9–35 months), 81
Achieving transmural lesions is critical for durable outcomes in catheter ablation. While electrogram amplitude reduction and pacing threshold changes have been reported as useful parameters, the optimal electrode configuration and cutoff values remain unclear. This preclinical study evaluated the efficacy of conventional and microelectrode configurations in predicting transmurality using the QDOT MICRO catheter. Radiofrequency ablation was performed in 14 swine, creating 131 atrial lesions. Pacing thresholds and electrogram amplitudes were measured before and after ablation using three configurations: conventional bipolar, microelectrode bipolar, and unipolar. Lesion transmurality was determined histologically. Receiver operating characteristic analyses were conducted to assess predictive accuracy. Among all configurations, the conventional bipolar (A1–A2) showed the highest predictive value. Post-ablation bipolar amplitudes were lower in transmural lesions (AUC 0.777, 0.86mV), with greater amplitude reduction (64.4
Real-time monitoring of myocardial tissue response during radiofrequency applications using a mesh-shaped flexible irrigation tip ablation catheter (TactiFlex) remains challenging. This study assessed the dynamics of averaged impedance drop percentage (AID
