TY - JOUR
T1 - The durability of pulmonary vein isolation using the visually guided laser balloon catheter
T2 - Multicenter results of pulmonary vein remapping studies
AU - Dukkipati, Srinivas R.
AU - Neuzil, Petr
AU - Kautzner, Josef
AU - Petru, Jan
AU - Wichterle, Dan
AU - Skoda, Jan
AU - Cihak, Robert
AU - Peichl, Petr
AU - Dello Russo, Antonio
AU - Pelargonio, Gemma
AU - Tondo, Claudio
AU - Natale, Andrea
AU - Reddy, Vivek Y.
N1 - Funding Information:
This study was supported by CardioFocus, Inc. Dr Neuzil, Dr Kautzner, Dr Dello Russo, Dr Tondo, and Dr Reddy received research grant support from CardioFocus, Inc.
PY - 2012/6
Y1 - 2012/6
N2 - 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 30° aiming arc was maneuvered around the PV and laser energy was delivered to ablate tissue in a contiguous/overlapping manner. At ∼3 months, all patients returned for a PV remapping procedure. Results: In 56 patients, 202 of 206 PVs (98%) were acutely isolated. At 105 ± 44 (mean ± 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 ± 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.
AB - 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 30° aiming arc was maneuvered around the PV and laser energy was delivered to ablate tissue in a contiguous/overlapping manner. At ∼3 months, all patients returned for a PV remapping procedure. Results: In 56 patients, 202 of 206 PVs (98%) were acutely isolated. At 105 ± 44 (mean ± 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 ± 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.
KW - Ablation
KW - Atrial fibrillation
KW - Endoscopic visualization
KW - Laser
KW - Paroxysmal
KW - Pulmonary veins
UR - http://www.scopus.com/inward/record.url?scp=84861333040&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2012.01.019
DO - 10.1016/j.hrthm.2012.01.019
M3 - Article
C2 - 22293143
AN - SCOPUS:84861333040
SN - 1547-5271
VL - 9
SP - 919
EP - 925
JO - Heart Rhythm
JF - Heart Rhythm
IS - 6
ER -