Novel Radiofrequency Balloon Catheter-Impact of Ablation Parameters on Single-Shot Isolation

Background: A novel multielectrode radiofrequency balloon (RFB) catheter has been released for pulmonary vein isolation (PVI). Methods and Results: In this observational study consecutive patients with drug-refractory paroxysmal or persistent atrial fibrillation (AF) undergoing first-time PVI were enrolled in 2 high-volume ablation centers. All procedures were conducted in conjunction with a 3D-mapping system. Clinical, procedural and ablation parameters were systematically analyzed. 105 patients (58% male; 52% paroxysmal AF, 68 & PLUSMN;11.3 years mean age, left atrial volume index 38.6 & PLUSMN;14.8 mL/m2) were included. 241/412 (58.5%) PVs were suc-cessfully isolated with a single shot (SS), with a time-to-isolation of 11.6 & PLUSMN;8 s. Total number of radiofrequency applications was 892 (mean 2.2/PV), resulting in successful isolation of 408/412 (99%) PVs at the end of the procedure. Mean electrodes' impedance drop was significantly higher in the SS-PVI compared with non-SS applications (21.5 & PLUSMN; 6.6 vs. 18.6 & PLUSMN;6.5 Ohm). Concordantly, higher tem-perature rise was observed in the SS vs. non-SS applications (10.9 & PLUSMN; 4.9 & DEG;C vs. 9.6 & PLUSMN;4.7 & DEG;C).Conclusions: In this multicenter real-world study, mean impedance drop and temperature rise were associated with successful SS-PVI applying the novel RFB catheter. These parameters may help to guide efficient usage of the new RF balloon.