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HotBalloon was originally invented by Dr Shutaro Satake, pioneer of Japanese cardiac electrophysiology and catheter ablation. It is now approved by Japanese Ministry of Welfare and Labour and reimbursed in Japan from 2016. It was developed after clinical investigation exclusively at Hayama Heart Center. Now it is distributed on commercial basis in Japan. HotBalloon is composed of a very compliant balloon with central electrode, which is inflated by infusion of normal saline. Energy source is radiofrequency. The saline within the balloon is heated by the central electrode. Then the heat is transmitted to the tissue in contact with the balloon membrane. Temperature within the balloon is maintained uniformly. The mechanism of heating is exclusively “conductive”, not Joule heating, which eliminates horrible “pop” phenomenon. The very compliant balloon profile enables to fit any site and any shape of pulmonary vein. The lesion which is created by HotBalloon is elegantly homogeneous. Besides electrical isolation of four pulmonary veins, carina between the pulmonary veins, left atrial roof and posterior wall can be ablated exclusively with HotBalloon. We have a lot of experience of HotBalloon ablation without causing collateral damage. At Hayama Heart Center, HotBalloon ablation is performed in collaboration with cardiac anaesthesiologists. During the hospital stay, the ward is located in full view of beautiful ocean and Mt. Fuji beyond.