Methods: A total of 21 patients with paroxysmal AF (n=16), persistent AF (n=2), and longstanding persistent AF (n=3) who were treated by RHBA were enrolled. During ablation, the temperature inside the balloon was maintained at 70 °C and esophageal temperature was monitored. Contrast medium diluted 1:2 with cold saline was injected into the esophagus through the nasopharyngeal tube so that the esophageal temperature does not exceed 39 °C. Aspiration was defined as bronchography during esophageal cooling contrast medium and saline infusion (Figure). We investigated the characteristics, outcomes, and complications of these patients.
Results: Mean follow-up duration was 333 ± 118 days, mean patient age was 70 years, and 19 patients were male. The average Body mass index (BMI) was 23.3 ± 3.2. Acute complete PV isolation using RHBA was 98.8% (83/84) of PVs and 95.2% (20/21) of patients. In 9 months of follow-up, AF recurred in only 1 (5.3%) patient. We encountered 8 (38.1%) patients with aspiration and 10 (47.6%) patients with postoperative fever. BMI (p=0.035), enlargement of left atrium diameter (p=0.048), PsAF (p=0.048) were significant factors for aspiration. Multivariate analysis revealed only BMI was a risk factor for aspiration (p=0.047). Conclusion: RHBA appeared to be effective for paroxysmal, persistent, and longstanding persistent AF patients in terms of chronic success rate after 9 months. Higher BMI patients should be monitored for aspiration due to esophageal cooling saline infusion.