We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Pulmonary vein isolation by visually guided laser balloon ablation: single-center 5-year follow-up results.
- Authors
Koopman, Pieter; Bekelaar, Thalia; Schurmans, Joris; Phlips, Thomas; Dilling-Boer, Dagmara; Vijgen, Johan
- Abstract
Background : Visually guided laser balloon (VGLB) ablation is a balloon-based treatment for atrial fibrillation (AF) that uses a titratable laser energy source to perform pulmonary vein isolation (PVI), allowing for real-time visualization of target tissue and ablation lesions through an endoscopic camera. Few long-term data on this technique are currently available. This report presents acute efficacy, procedural data, complication rates, and long-term AF-free survival up to 5 years post-ablation. Methods: In this single-center, retrospective, observational report, 152 patients (72.4% male, mean age 60.6 ± 9.7 years, 62.5% paroxysmal AF, 598 pulmonary veins in total) treated with the first-generation VGLB system between 2014 and 2016 were included for analysis. AF ablation consisted of PVI only. Results: Acute PVI was achieved in 98.2% of veins, with first-pass isolation in 92.5%. Procedure duration of 129 min [IQR 113–150], fluoroscopy time of 15 min [IQR 11–20], and dose area product of 5016 mGy·cm2 [IQR 3603–8711] were recorded. During a median follow-up of 51 months [IQR 45–57], 74.3% of patients remained free of AF (78.8% for paroxysmal and 65.3% for persistent AF, p = 0.108). Freedom of AF at 1, 2, 3, and 4 years follow-up was 88.2%, 82.2%, 78.9%, and 74.8%, respectively. PV reconnections were identified in only 46.9% of redo procedures. The median number of PV reconnections during redo procedures was 0 [IQR 0–2]. Anti-arrhythmic drug use was significantly reduced after ablation (p < 0.001). The most commonly reported complications were minor vascular complications (4.6%) and transient phrenic nerve paralysis (3.3%). Conclusions: First-generation VGLB ablation demonstrated high acute isolation rates, reasonable procedure times and low complication rates. Long-term freedom from AF was 78.8% for paroxysmal AF and 65.3% for persistent AF, performing PVI only.
- Subjects
PULMONARY veins; FLUOROSCOPY; LASER ablation; PHRENIC nerve; ATRIAL fibrillation; DRUG utilization
- Publication
Journal of Interventional Cardiac Electrophysiology, 2023, Vol 66, Issue 9, p2081
- ISSN
1383-875X
- Publication type
Article
- DOI
10.1007/s10840-023-01544-6