Single Shot PVI With Balloon-in-Basket Technology | RIO 2024 US Focus

Chair Bradley Knight (Chicago, US) led a session on single-shot pulmonary vein isolation (PVI) using balloon and basket technology, featuring case operator Roland Tilz (Lübeck, DE) and panellists Andrea Natale (Austin, US) and Nitesh Sood (Boston, US). The discussion focused on the Volt system, a second-generation pulsed field ablation (PFA) catheter designed for improved tissue contact, stable lesion creation, and reduced microbubble formation. The faculty reviewed key procedural steps, including transeptal puncture, catheter navigation, and the importance of real-time mapping integration. The session highlighted the Volt catheter’s ability to optimise electrode spacing via its balloon mechanism and deliver energy selectively to different anatomical targets, enhancing safety and efficacy. The panel also discussed the catheter’s performance in the Volt trial, which demonstrated high success in pulmonary vein isolation. Concerns about phrenic nerve pacing were addressed, with Tilz explaining the trial’s conservative approach to minimising risks. The discussion covered the importance of 3D mapping for anatomical accuracy and the potential future role of Volt beyond pulmonary veins. The session concluded with insights into upcoming regulatory approval in Europe and reflections on the evolving landscape of PFA technology.