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Hot balloon vs. cryoballoon ablation for persistent atrial fibrillation: lesion area, efficacy, and safety
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  • Yuji Wakamatsu,
  • Koichi Nagashima,
  • Reiko Fukuda,
  • Naoki Nishiyama,
  • Ryuta Watanabe,
  • Masaru Arai,
  • Naoto Otsuka,
  • Sayaka Kurokawa,
  • Hirotsugu Sato,
  • Tetsuya Ishikawa,
  • Yuichi Hori,
  • Yasuo Okumura,
  • Isao Taguchi
Yuji Wakamatsu
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Koichi Nagashima
Nihon University School of Medicine
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Reiko Fukuda
Dokkyo Medical University Saitama Medical Center
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Naoki Nishiyama
Dokkyo Medical University Saitama Medical Center
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Ryuta Watanabe
Nihon University School of Medicine
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Masaru Arai
Nihon University School of Medicine
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Naoto Otsuka
Nihon University School of Medicine
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Sayaka Kurokawa
Nihon University School of Medicine
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Hirotsugu Sato
Dokkyo Medical University Saitama Medical Center
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Tetsuya Ishikawa
Dokkyo Medical University Saitama Medical Center
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Yuichi Hori
Dokkyo Medical University Saitama Medical Center
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Yasuo Okumura
Nihon University School of Medicine
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Isao Taguchi
Dokkyo Medical University Saitama Medical Center
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Abstract

Introduction: The clinical efficacy and safety of hot balloon ablation (HBA) for treatment of persistent AF (PerAF) remain unclear. We aimed to evaluate the clinical efficacy and safety of HBA vs. cryoballoon ablation (CBA) as treatment for PerAF. Methods: Of 195 consecutive patients who underwent initial catheter ablation for PerAF (AF lasting >7 days but <12 months), 158 propensity score-matched (79 HBA and 79 CBA) patients were included in our study. All patients who underwent HBA received applications of energy to the upper posterior LA wall with a larger balloon in addition to single shots to each pulmonary vein (PV) ostium, whereas those who underwent CBA received simple single-shot applications. The electrically isolated surface area (ISA), including the PV antrum and part of the posterior LA wall, was assessed by high-resolution mapping. Results: Success of the PV isolation with balloon shots alone did not differ between HBA and CBA (81% vs. 85%; P = 0.52). The ISA was generally wide in both groups and significantly larger in the HBA group than in the CBA group (61 ± 16% vs. 51 ± 12%, P < 0.001). The incidence of procedure-related complications did not differ significantly (HBA 4% vs. CBA 1%; P = 0.62) nor did the arrhythmia recurrence rate (HBA 11% vs. CBA 18% at 18 months; P = 0.26). Conclusion: Despite the difference in protocols, HBA and CBA performed for PerAF appear comparable in terms of wide antral lesion creation, clinical efficacy, and safety.

Peer review status:ACCEPTED

14 Apr 2020Submitted to Journal of Cardiovascular Electrophysiology
15 Apr 2020Submission Checks Completed
15 Apr 2020Assigned to Editor
15 Apr 2020Reviewer(s) Assigned
23 Apr 2020Review(s) Completed, Editorial Evaluation Pending
24 Apr 2020Editorial Decision: Revise Minor
17 May 20201st Revision Received
19 May 2020Assigned to Editor
19 May 2020Submission Checks Completed
19 May 2020Reviewer(s) Assigned
04 Jun 2020Review(s) Completed, Editorial Evaluation Pending
08 Jun 2020Editorial Decision: Revise Minor
12 Jun 20202nd Revision Received
13 Jun 2020Submission Checks Completed
13 Jun 2020Assigned to Editor
13 Jun 2020Reviewer(s) Assigned
22 Jun 2020Review(s) Completed, Editorial Evaluation Pending
23 Jun 2020Editorial Decision: Accept