Background: The visually guided laser ablation (VGLA) catheter is a compliant, variable-diameter balloon that delivers laser energy around the pulmonary vein (PV) ostium under real-time endoscopic visualization. While acute PV isolation has been shown to be feasible, limited data exist regarding the durability of isolation. Objective: We sought to determine the durability of PV isolation following ablation using the balloon-based VGLA catheter. Methods: The VGLA catheter was evaluated in patients with paroxysmal atrial fibrillation (3 sites, 10 operators). Following transseptal puncture, the VGLA catheter was advanced through a 12-F deflectable sheath and inflated at the target PV ostium. Under endoscopic guidance, the 30Â° aiming arc was maneuvered around the PV and laser energy was delivered to ablate tissue in a contiguous/overlapping manner. At â¼3 months, all patients returned for a PV remapping procedure. Results: In 56 patients, 202 of 206 PVs (98%) were acutely isolated. At 105 Â± 44 (mean Â± SD) days, 52 patients returned for PV remapping at which time 162 of 189 PVs (86%) remained isolated and 32 of 52 patients (62%) had all PVs still isolated. On comparing the operators performing <10 vs <10 procedures, the durable PV isolation rate and the percentage of patients with all PVs isolated were found to be 73% vs 89% (P =.011) and 57% vs 66% (P =.746), respectively. After 2 procedures and 12.0 Â± 1.9 months of follow-up, the drug-free rate of freedom from atrial fibrillation was 71.2%. Conclusions: In this multicenter, multioperator experience, VGLA resulted in a very high rate of durable PV isolation with a clinical efficacy similar to that of radiofrequency ablation.
The durability of pulmonary vein isolation using the visually guided laser balloon catheter: Multicenter results of pulmonary vein remapping studies / S.R. Dukkipati, P. Neuzil, J. Kautzner, J. Petru, D. Wichterle, J. Skoda, R. Cihak, P. Peichl, A. Dello Russo, G. Pelargonio, C. Tondo, A..P.L. Natale, V.Y. Reddy. - In: HEART RHYTHM. - ISSN 1547-5271. - 9:6(2012), pp. 919-925.
|Titolo:||The durability of pulmonary vein isolation using the visually guided laser balloon catheter: Multicenter results of pulmonary vein remapping studies|
|Parole Chiave:||Ablation; Atrial fibrillation; Endoscopic visualization; Laser; Paroxysmal; Pulmonary veins; Adolescent; Adult; Aged; Angiography; Angioscopy; Atrial Fibrillation; Catheter Ablation; Catheterization; Electrophysiologic Techniques, Cardiac; Equipment Design; Feasibility Studies; Female; Follow-Up Studies; Heart Conduction System; Humans; Imaging, Three-Dimensional; Laser Therapy; Male; Middle Aged; Pulmonary Veins; Time Factors; Treatment Outcome; Young Adult; Cardiology and Cardiovascular Medicine; Physiology (medical)|
|Settore Scientifico Disciplinare:||Settore MED/11 - Malattie dell'Apparato Cardiovascolare|
|Data di pubblicazione:||2012|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.hrthm.2012.01.019|
|Appare nelle tipologie:||01 - Articolo su periodico|