High-intensity focused ultrasound via a balloon catheter achieved acute pulmonary vein isolation in 81% of targeted veins, with 71% of patients free from atrial fibrillation recurrence at 342 days.
Observational (n=22)
Does high-intensity focused ultrasound via balloon catheter safely and effectively achieve pulmonary vein isolation in patients with paroxysmal atrial fibrillation?
The third-generation HIFU balloon catheter with a steerable sheath enables rapid pulmonary vein isolation in paroxysmal AF, but carries a notable risk of collateral damage.
AIMS: High-intensity focused ultrasound (HIFU) applied via a balloon catheter (BC) is a novel technology for simplified pulmonary vein isolation (PVI). Safety and efficacy of the third generation HIFU-BC were assessed. METHODS AND RESULTS: In 22 patients (10 male, mean age 65 +/- 6 years) with paroxysmal atrial fibrillation (PAF), a PVI during real-time PV spike registration and oesophageal temperature measurement was attempted. In 15 patients, a steerable sheath was used along with the HIFU-BC. In 67 of 83 PVs (81%), PVI was achieved exclusively using HIFU. Using the steerable sheath, the acute PVI rate rose from 50% (10/20 PVs) to 90% (57/63 PVs). In the latter, PVI was achieved with a single HIFU application in 60% (38/63 PVs) and mean sonication time of 11 +/- 7 s. The mean procedure time was 166 +/- 74 min including 58 +/- 25 min of HIFU-BC left atrial indwelling time. In four patients, peri-procedural complications occurred (one transient ischaemic attack, one phrenic nerve palsy, and two vascular access complications). During a median follow-up of 342 days (range 272-378 days), 71% patients remained free of any AF/AT recurrence without antiarrhythmic drugs after a single procedure. CONCLUSION: The novel defocused 12F HIFU-BC used in conjunction with a steerable sheath allows for very rapid PVI in patients with PAF. The enthusiasm for rapid PVI is still dampened by the potential risk of collateral damage.
Schmidt et al. (Tue,) conducted a observational in Paroxysmal atrial fibrillation (PAF) (n=22). High-intensity focused ultrasound (HIFU) via balloon catheter was evaluated on Acute pulmonary vein isolation (PVI) rate exclusively using HIFU. High-intensity focused ultrasound via a balloon catheter achieved acute pulmonary vein isolation in 81% of targeted veins, with 71% of patients free from atrial fibrillation recurrence at 342 days.