循環器ジャーナル72巻3号

2024年07月発行

特集 心房細動—予防・早期発見・治療の進化 Ⅳ.非薬物治療（アブレーションから外科的手術）

バルーンアブレーション

著者： 小堀敦志¹

所属機関： ¹神戸市立医療センター中央市民病院循環器内科

ページ範囲：P.416 - P.423

POINT
●簡便・確実・安全，そして迅速に肺静脈隔離を達成できるバルーンアブレーションが広まっている．
●クライオバルーンは，高い臨床効果と安全性により持続性心房細動や発作性心房細動の第一選択治療としても適応が広がっている．
●ホットバルーンでは表面温度モニタリング，レーザーバルーンでは自動回転照射といった新機能が登場し，効果が期待されている．

参考文献

1）Kuck KH, Brugada J, Fürnkranz A, et al. Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation. N Engl J Med 2016 ; 374 : 2235-45.

2）Kuck KH, Fürnkranz A, Chun KR, et al. Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial fibrillation : reintervention, rehospitalization, and quality-of-life outcomes in the FIRE AND ICE trial. Eur Heart J 2016 ; 37 : 2858-65.

3）Kimura M, Kobori A, Nitta J, et al. Cryoballoon ablation for paroxysmal atrial fibrillation in Japan : 2-year safety and efficacy results from the Cryo AF Global Registry. J Interv Card Electrophysiol 2022 ; 64 : 695-703.

4）Providencia R, Defaye P, Lambiase PD, et al. Results from a multicentre comparison of cryoballoon vs. radiofrequency ablation for paroxysmal atrial fibrillation : is cryoablation more reproducible? Europace 2017 ; 19 : 48-57.

5）Su WW, Reddy VY, Bhasin K, et al. Cryoballoon ablation of pulmonary veins for persistent atrial fibrillation : Results from the multicenter STOP Persistent AF trial. Heart Rhythm 2020 ; 17 : 1841-7.

6）Kobori A, Sasaki Y, Pak M, et al. Comparison of Cryoballoon and Contact Force-Sensing Radiofrequency Ablation for Persistent Atrial Fibrillation in Clinical Practice. Circ J 2022 ; 86 : 290-8.

7）Miyazaki S, Kobori A, Sasaki Y, et al. Real-World Safety Profile of Atrial Fibrillation Ablation Using a Second-Generation Cryoballoon in Japan : Insight From a Large Multicenter Observational Study. JACC Clin Electrophysiol 2021 ; 7 : 604-13.

8）Shinoda Y, Yamasaki H, Murakoshi N, et al. Balloon surface temperature-controlled ablation using a second-generation radiofrequency HotBalloon : an in vivo feasibility study. Europace 2023 ; 25 : euad340.

9）Yamasaki H, Nakahara S, Sohara H, et al. HotBalloon Pulmonary Vein Isolation Registry Study - Real-World Efficacy and Safety of HotBalloon Ablation. Circ J 2022 ; 87 : 65-73.

10）Goya M, Hirao K, Aonuma K, et al. Initial multicenter clinical experience with the first-generation endoscopic guided laser balloon in Japan. J Interv Card Electrophysiol 2023 ; 66 : 1713-21.

11）Kobori A, Sasaki Y, Pak M, et al. Early experiences with three types of balloon-based ablation catheters in patients with paroxysmal atrial fibrillation. Heart Rhythm O2 2021 ; 2 : 223-30.

12）Funasako M, Petrů J, Hála P, et al. Acute and long-term results with the 3rd generation visually guided laser balloon ablation system for pv isolation. J Interv Card Electrophysiol 2024 ; 67 : 53-60.