Fukunaga Hiroshi, Sekiguchi Yukio, Asano Sou, Nagase Takahiko, Tanizaki Kohei, Umemura Jun, Nitta Junichi, Isobe Mitsuaki
Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Tokyo 183-0003, Japan.
Int J Cardiol Heart Vasc. 2022 Feb 3;39:100967. doi: 10.1016/j.ijcha.2022.100967. eCollection 2022 Apr.
A surface temperature sensor can be used to visualize the effect of hot balloon (HB) catheters. This study evaluated the efficacy and safety of a second-generation HB system with surface temperature monitoring in patients with atrial fibrillation (AF).
Twenty patients (age: 69.6 ± 9.7 years, 11 male participants) who underwent first-time pulmonary vein isolation (PVI) using a second-generation HB were included. For each pulmonary vein (PV), the acute isolation rate and effective therapeutic range of surface temperature were investigated.
Eighty-three PVs (including three right middle PVs) were isolated in 20 patients using an HB with a surface temperature sensor. Sixty-eight PVs were isolated using the first application. Fifteen PVs (left superior PV [LSPV], n = 7 [35%]; left inferior PV, n = 2 [10%]; right superior PV, n = 3 [15%]; right inferior PV, n = 3 [15%]) showed early intraoperative reconduction and required second applications. One LSPV required radiofrequency touch-up at the carina. The optimal balloon surface temperature and application time were evaluated, and a median value of 58 °C and integral value of 1000 °C·s were identified from the receiver operating characteristic curve to be useful effective indicators. However, for LSPV, the PV potential of carina or ridge likely often remained and needed to be independently considered. There was no periprocedural complication including severe pulmonary vein stenosis. During the observation period (median: 280 days, interquartile range: 261-318 days), 17 patients (85%) achieved and maintained sinus rhythm.
Second-generation HBs with a surface temperature sensor are expected to provide favorable outcomes in AF ablation treatment.
表面温度传感器可用于可视化热球囊（HB）导管的效果。本研究评估了具有表面温度监测功能的第二代HB系统在心房颤动（AF）患者中的疗效和安全性。
纳入20例首次使用第二代HB进行肺静脉隔离（PVI）的患者（年龄：69.6±9.7岁，11例男性参与者）。对每条肺静脉（PV），研究其急性隔离率和表面温度的有效治疗范围。
20例患者使用带有表面温度传感器的HB隔离了83条PV（包括3条右中PV）。首次应用时隔离了68条PV。15条PV（左上肺静脉[LSPV]：n = 7 [35%]；左下肺静脉：n = 2 [10%]；右上肺静脉：n = 3 [15%]；右下肺静脉：n = 3 [15%]）在术中早期出现再传导，需要再次应用。1条LSPV在隆突处需要射频补点。评估了最佳球囊表面温度和应用时间，从受试者工作特征曲线确定58°C的中位数和1000°C·s的积分值为有用的有效指标。然而，对于LSPV，隆突或嵴处的PV电位可能经常残留，需要单独考虑。没有包括严重肺静脉狭窄在内的围手术期并发症。在观察期（中位数：280天，四分位间距：261 - 318天），17例患者（85%）实现并维持窦性心律。
带有表面温度传感器的第二代HB有望在AF消融治疗中提供良好的结果。
