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Relationship between aspiration and body mass index by radiofrequency hot balloon ablation of atrial fibrillation

Session Poster session 3

Speaker Takahiro Okano

Congress : EHRA 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Rhythm Control, Catheter Ablation
  • Session type : Poster Session
  • FP Number : P1455

Authors : T Okano (Matsumoto,JP), A Okada (Matsumoto,JP), H Kobayashi (Matsumoto,JP), W Shoin (Matsumoto,JP), K Yoshie (Matsumoto,JP), M Shoda (Matsumoto,JP), K Kuwahara (Matsumoto,JP)

T Okano1 , A Okada1 , H Kobayashi1 , W Shoin1 , K Yoshie1 , M Shoda1 , K Kuwahara1 , 1Shinshu University, cardiovascular medicine - Matsumoto - Japan ,


Background: Radiofrequency hot balloon ablation (RHBA) is an established procedure for pulmonary vein (PV) isolation in atrial fibrillation (AF). However, there are few reports on aspiration, one of the important complications of RHBA. In this study, we aim to clarify our clinical effect and factors related to aspiration of RHBA.

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.

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