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Journal of Interventional Cardiac Electrophysiology
Erschienen in:

01.03.2024

Quantitative comparison of the isolation lesions between conventional- and larger-sized visually guided laser balloon ablation

verfasst von: Takashi Yamasaki, Ken Kakita, Misun Pak, Tetsuhisa Hattori

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 5/2024

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Abstract

Background

The importance of a wider circumferential isolation of the pulmonary veins (PV), which includes a large portion of the left atrial posterior wall (LAPW), has been suggested in several studies. However, the extended isolation area using a larger inflated visually guided laser balloon (VGLB) ablation remains to be elucidated.

Methods

Seventy-eight patients with atrial fibrillation (AF) who underwent VGLB ablation were enrolled in this prospective study. An electroanatomic map of the left atrium was obtained before and after PV isolation (PVI) using a conventional-sized VGLB. The isolation areas were extended by the largest-sized VGLB ablation and remapped in the same manner. After the ablation, isolation areas were calculated with CARTO-3 system. The one-year atrial arrhythmia (Ata) recurrence was assessed. 

Results

The largest-sized VGLB ablation yielded statistically greater areas of isolation in left-sided PV antrum (PVA) (11.5 ± 2.3 cm2 vs. 15.9 ± 3.5 cm2, P < .001) and right-sided PVA (14.2 ± 3.3 cm2 vs. 20.6 ± 4.4 cm2, P < .001) than the conventional-sized VGLB. Further, non-ablated LAPW (12.3 ± 4.4 cm2 vs. 7.8 ± 3.9 cm2, P < .001) was significantly reduced after largest-sized VGLB ablation, compared to the conventional-sized VGLB ablation. The one-year Ata freedom was 83.7% in patients with paroxysmal AF and 96.4% in those with persistent AF.

Conclusion

The largest-sized VGLB ablation technique can create a significantly wider isolation area of PVA and debulk a large amount of LAPW than the conventional-sized VGLB ablation. The one-year outcome was similarly high in paroxysmal and persistent AF.

Graphical Abstract

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Metadaten
Titel
Quantitative comparison of the isolation lesions between conventional- and larger-sized visually guided laser balloon ablation
verfasst von
Takashi Yamasaki
Ken Kakita
Misun Pak
Tetsuhisa Hattori
Publikationsdatum
01.03.2024
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 5/2024
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-024-01738-6

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