Prospective evaluation of antral lesion size of the 31-mm size of a novel size-adjustable cryoballoon: Results of the BETTER-FIT study

Figures

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  Figure 1. Overview of measurements pre- and postablation. A: Preablation measurements consisted of posterior wall surface area, and superior, middle, and inferior lines. B: Postablation measurements consisted of unablated posterior wall surface area, and superior, middle, and inferior lines using a cutoff value of 0.3 mV. C: Postablation measurements focusing on posterior antral lesion area at the level of each pulmonary vein. D: Postablation measurements focusing on antral lesion area on each side and the pulmonary vein ostia area. Note that the pulmonary veins were deleted to prevent overestimation of the antral lesion area.

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  Figure 2. Grade 4 occlusion grade between the 28-mm and 31-mm cryoballoon size of the different pulmonary veins. There was a trend toward lower grade 4 occlusion in the right superior pulmonary vein (RSPV) with the 31-mm balloon size in comparison to the 28-mm balloon size (P = .08). Green bar denotes the grade 4 occlusion grade with either the 28- or 31-mm balloon size. Note there was no increase in grade 4 occlusion grade with both sizes in comparison to the 28-mm size only. LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right inferior pulmonary vein.

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  Figure 3. Summary of the characteristics of antral lesion size after ablation with the 31-mm balloon size. The nonablated posterior wall forms a trapezium with the smallest dimensions at the superior line (2.3 ± 0.9 cm) and the longest dimensions at the inferior line (2.9 ± 0.8 cm). Approximately one-third of the posterior wall is ablated (35.4% ± 13.8%). LAA = left atrial appendage; other abbreviations as in Figure 2.

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  Figure 4. A: Inadvertent roof line in a study patient. B: Correlation between preablation superior line and postablation superior line. Pearson correlation = 0.66 (P = .002). The lower boundary of the 95% confidence interval transects the 10-mm postablation superior line at 27 mm (dashed line). Asterisks denote the patient with postablation inadvertent roof line. Abbreviations as in Figure 2.