Electrical Isolation of Pulmonary Veins Using Laser Catheter in the Treatment of Paroxysmal and Persistent Atrial Fibrillation. One-year Results

Rev Esp Cardiol (Engl Ed). 2016 May;69(5):488-93. doi: 10.1016/j.rec.2015.08.022. Epub 2015 Dec 10.
[Article in English, Spanish]

Abstract

Introduction and objectives: A new laser balloon that allows visualization of atrial tissue has recently been introduced for pulmonary vein electrical isolation. The aim of this study was to evaluate the mid-term safety and efficacy of this catheter in the treatment of atrial fibrillation.

Methods: Laser balloon ablation was performed in 71 patients with paroxysmal (80%) or persistent (20%) atrial fibrillation. Arrhythmia recurrence was defined as any episode lasting longer than 30 seconds. During follow-up, regular visits were performed every 3 months with 24- to 48-hour Holter tests.

Results: Isolation was possible in 275 of 278 (99%) of pulmonary veins. Mean procedure and fluoroscopy times were 154 ± 25 and 34 ± 15minutes, respectively. A total of 89% of veins were isolated during the first attempt. The most common complication was phrenic nerve paralysis (5.6%), which appeared in only the first 18 cases. A total of 59 patients received follow-up for a mean of 420 ± 193 days, with a rate of arrhythmia recurrence of 12% and 30%, respectively, in paroxysmal and persistent atrial fibrillation (P = .155).

Conclusions: The laser balloon is a safe and effective system for pulmonary vein electrical isolation. Its advantages include the capacity to adapt to pulmonary vein anatomy using a single catheter, the efficacy with which pulmonary vein electrical isolation is achieved, and the favorable mid-term clinical progress, even for patients with persistent atrial fibrillation.

Keywords: Ablación; Ablation; Atrial fibrillation; Catéter láser; Fibrilación auricular; Laser catheter.

MeSH terms

  • Adult
  • Aged
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / instrumentation
  • Catheter Ablation / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Laser Therapy / instrumentation
  • Laser Therapy / methods*
  • Male
  • Middle Aged
  • Operative Time
  • Peripheral Nervous System Diseases / epidemiology
  • Phrenic Nerve
  • Postoperative Complications / epidemiology
  • Pulmonary Veins / surgery*
  • Recurrence
  • Treatment Outcome