scholarly journals Third-generation laser balloon ablation: rapid mode applicability is associated with shorter time to pulmonary vein isolation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Martignani ◽  
M Ziacchi ◽  
G Statuto ◽  
L Bartoli ◽  
A Spadotto ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Funding Sources ◽  
Successful Isolation ◽  
Procedural Time ◽  
Balloon Ablation ◽  
Mode Energy ◽  
Manual Mode ◽  
Laser Balloon Ablation ◽  
Laser Balloon

Abstract Background The rapid mode feature implemented in the latest version of the laser balloon system (LB3, HeartLight, X3, Cardiofocus) offers an automated continuous 360° lesion for pulmonary vein isolation (PVI). However, data on its clinical applicability and the potential reduction of procedural times are not yet available. Purpose To explore the use of the rapid mode and its association with PV total and fluoroscopy times in our initial experience with LB3. Methods This analysis included consecutive patients who underwent PVI procedure with LB3. We attempted to perform a complete circular ablation line using the rapid mode at 13 W, but if needed to achieve successful isolation, rapid mode was interrupted and manual mode (5.5–8.5 W) applications were used. The percentage of rapid mode use on the 360° lesion was measured for each PV. Total and fluoroscopy times to complete PVI were also collected. Results A total of 110 PVs were identified in 27 LB3 procedures and successfully isolated with a mean procedural time of 85±31 min. Sixty (55%) PVs were treated by using rapid mode for more than 50% (180°) lesion and 13 (12%) of them had a pure rapid mode ablation (without necessity of manual mode applications). Right inferior PV had the highest use of rapid mode (median value 70%). The main reasons for manual applications were poor PV occlusion, imperfect ostium visualization and presence of blood. PVs with >50% rapid mode use were treated in a significantly shorter time (21.2±13.7 vs 26.8±12.4, p=0.043). Fluoroscopy time did not differ significantly (4.7±4.2 vs 5.4±4.9, p=0.48). Three pinhole balloon ruptures were observed during rapid mode energy application in the second, third and twenty-fifth procedure. No other complications occurred. Conclusions Few PVs could be isolated using pure rapid mode; however, its applicability for more than 50% lesion was observed more frequently and significantly reduced the time to isolation. FUNDunding Acknowledgement Type of funding sources: None. Time to isolation using Rapid Mode

scholarly journals 136-15: First Belgian experience with the Endoscopic laser balloon Ablation System for pulmonary vein isolation – 1 year follow-up

EP Europace ◽  
2016 ◽  
Vol 18 (suppl_1) ◽  
pp. i93-i93
Author(s):  
Pieter Koopman ◽  
Jeff Ten Haken ◽  
Philippe Vanduynhoven ◽  
Dagmara Dilling-Boer ◽  
Joris Schurmans ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Endoscopic Laser ◽  
Balloon Ablation ◽  
Laser Balloon Ablation ◽  
Laser Balloon

scholarly journals Real use of a novel automatic motorized laser balloon for the ablation of atrial fibrillation

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
C Martignani ◽  
M Ziacchi ◽  
G Statuto ◽  
A Spadotto ◽  
A Angeletti ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Control System ◽  
Pulmonary Vein ◽  
Laser Energy ◽  
Pulmonary Veins ◽  
Endoscopic Ablation ◽  
Motor Control System ◽  
Balloon Ablation ◽  
Laser Balloon Ablation ◽  
Laser Balloon

Abstract Funding Acknowledgements Type of funding sources: None. Background Electric isolation of the pulmonary veins (PVs) can successfully treat patients with atrial fibrillation (AF). Isolation of pulmonary veins can be achieved by several methods: radiofrequency, cryoballoon or laser balloon ablation (LBA). The main procedural challenge with either method is to achieve a continuous circumferential lesion at the left atrium-PVs junction, with the persistence of functional gaps. Purpose A novel endoscopic ablation system equipped with a precise motor control system (MCS) has been evaluated. The balloon is used with an endoscope to directly visualize and ablate tissue at the left atrial-PVs junction with laser energy. This system enables uninterrupted, high-speed, circumferential lesion creation under direct control of the physician. The MCS is intended to reduce procedure time and to ensure continuity of ablation lesions. The feasibility of the motorized ablation in terms of extent of applicability along each PV-left atrium junction and time of use of the manual point-by-point mode has been investigated. Methods sixteen consecutive patients (male 68.7%, age 60.9 ± 7.8 years) with paroxysmal or persistent AF who underwent LBA were enrolled in our institution. Exclusion criteria were any contraindication for the procedure including the presence of intracavitary thrombosis and contraindications to general anesthesia or deep sedation. After transseptal puncture, the balloon-based endoscopic ablation system was advanced to each PV ostium, and laser energy were projected onto the target. Results A total of 62 PVs were treated with LBA; in 3 patients there was a redundant right intermediate pulmonary vein; in 4 patients there was a right common ostium and in one a left common ostium. MCS was used for 41 PVs (66.1%): in particular, MCS was used continuously between 180° and 325° degrees (50 to 90% of PV circumference) for 22 PVs (35.5%) and between 326° and 359° degrees (91 to 99% of PV circumference) for 16 veins (25.8%).  In 3 PVs (4.8%) MCS was used for the entire circumference.  During 5.659 (23.6%) seconds out of a total of 23.986 seconds, laser energy delivery occurred in the rapid mode by MCS. No clinical complications, either local or systemic (stroke or TIA, pericardial effusion, pericardial  tamponade, pulmonary vein stenosis, esophageal injury, temporary or permanent phrenic nerve palsy), were observed neither during the use of MSC nor during the use of manual point-by-point mode. Of note, a pinhole rupture of the balloon occurred in the first 2 cases of our series, during the use of MCS, without harm to the patient and requiring only replacement of the LBA. Conclusions In our case series, laser balloon ablation with the help of motor control system appears safe and feasible in most cases for large portions of pulmonary vein circumference, providing considerable time sparing (66.1% of total ablation extent in 23.6% of total ablation time).

Pulmonary vein narrowing after visually guided laser balloon ablation: Occurrence and clinical correlates

2020 ◽  
Vol 31 (7) ◽  
pp. 1597-1605
Author(s):  
Tasuku Yamamoto ◽  
Yoshihide Takahashi ◽  
Junji Yamaguchi ◽  
Masahiro Sekigawa ◽  
Yasuhiro Shirai ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Visually Guided ◽  
Clinical Correlates ◽  
Balloon Ablation ◽  
Laser Balloon Ablation ◽  
Laser Balloon

scholarly journals Pulmonary Vein Stenosis After Laser Balloon Ablation for Atrial Fibrillation

2015 ◽  
Vol 1 (3) ◽  
pp. 220-221 ◽  
Author(s):  
Narendra Kumar ◽  
Laurent Pison ◽  
Yuri Blaauw ◽  
Carl Timmermans ◽  
Mark La Meir ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Stenosis ◽  
Balloon Ablation ◽  
Vein Stenosis ◽  
Laser Balloon Ablation ◽  
Laser Balloon
Sign in / Sign up

Export Citation Format

Share Document