P1026Second-generation visually guided laser balloon ablation system for pulmonary vein isolation: Learning curve, safety and efficacy: The MERLIN registry

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
C H Heeger ◽  
H L P Phan ◽  
R M S Meyer-Saraei ◽  
T F Fink ◽  
V S Sciacca ◽  
...  

Abstract Funding Acknowledgements Cardiofocus Background Radiofrequency (RF) based pulmonary vein isolation (PVI) results in favourable clinical outcome, although its complexity demands a long learning curve. Balloon-based systems, have been developed to possibly solve these limitations. The second-generation laser balloon (LB2) offers optimized features for improved tissue contact and visibility. Purpose We determined safety, efficacy and learning curve of the LB2 for PVI. Method A total of 45 consecutive patients (89% persistent AF) were prospectively enrolled and divided in three groups (T1, T2, T3) of n = 15 patients per group. All patients underwent PVI using the LB2 by two operators. The operators were experienced in RF and cryothermal procedures, but not in laser ablations. Results A total 174/177 PVs (98%) were successfully isolated. The median procedure time significantly declined from 132 (114, 158) to 119 (102, 127) and 91 (86, 105) min in T 1–3, respectively (P = 0.0009). Similarly, the median fluoroscopy time significantly decreased from T1 until T3 (22 (17, 27) vs. 21 (16, 24) vs. 13 (10, 17) min, respectively, P = 0.045. Adverse events occurred in 6.7% with a trend towards a lower complication rate with increasing experience. Conclusion The LB2 was safe and effective for PVI even for operators without any previous experience in laser balloon based PVI. Procedure time LA dwelling time and fluoroscopy time decreased after a learning curve of 15 cases.

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S125-S126
Author(s):  
Takashi Yamasaki ◽  
Tetsuhisa Hattori Keisuke Ohta ◽  
Nobuyuki Miyai, Reo Nakamura ◽  
Takayoshi Sawanishi Noriyuki Kinosita ◽  
Ken Kakita

2015 ◽  
Vol 66 (12) ◽  
pp. 1350-1360 ◽  
Author(s):  
Srinivas R. Dukkipati ◽  
Frank Cuoco ◽  
Ilana Kutinsky ◽  
Arash Aryana ◽  
Tristram D. Bahnson ◽  
...  

2020 ◽  
Vol 31 (7) ◽  
pp. 1597-1605
Author(s):  
Tasuku Yamamoto ◽  
Yoshihide Takahashi ◽  
Junji Yamaguchi ◽  
Masahiro Sekigawa ◽  
Yasuhiro Shirai ◽  
...  

2015 ◽  
Vol 26 (9) ◽  
pp. 944-949 ◽  
Author(s):  
SRINIVAS R. DUKKIPATI ◽  
IAN WOOLLETT ◽  
H. THOMAS McELDERRY ◽  
MARIE‐CHRISTINE BÖHMER ◽  
SHEPHAL K. DOSHI ◽  
...  

EP Europace ◽  
2016 ◽  
Vol 18 (suppl_1) ◽  
pp. i93-i93
Author(s):  
Pieter Koopman ◽  
Jeff Ten Haken ◽  
Philippe Vanduynhoven ◽  
Dagmara Dilling-Boer ◽  
Joris Schurmans ◽  
...  

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Yamasaki ◽  
T Hattori ◽  
K Kakita ◽  
K Oota ◽  
N Miyai ◽  
...  

Abstract Background The visually guided laser balloon ablation is a balloon-based catheter ablation technology used for atrial fibrillation (AF) ablation in recent years. This balloon catheter consists of a compliant balloon that has the capability of real-time endoscopic visualization of the targeted pulmonary vein (PV). The sizeable balloon is usually inflated to obtain optimal PV occlusion. The isolation area after laser balloon (LB) ablation was reported to be smaller than that after cryoballoon ablation. However, when LB is inflated with its maximum pressure, it can visualize wide-area PV antrum. Thereby, we suspected that larger-size LB can create wider isolation area. Purpose The aim of this study is to quantitatively evaluate the isolation area after LB ablation at the size larger than appropriate size for ablation in the pulmonary vein carina region. Methods We assessed 66 patients with AF who underwent LB ablation at the larger inflation size in our hospital during the period from July 2018 to July 2019. After LB ablation, we created voltage maps with a circular mapping catheter and calculated isolation areas with CARTO system. Results Figure shows a larger LB with its maximum pressure. PV antrum isolation was extended to the posterior wall in all patients. The left- and right-sided pulmonary vein antrum isolation area were 15.1±3.9 and 19.4±4.3 cm2, respectively. Conclusion LB at the larger inflation size with its maximum pressure can isolate wider-area circumferential PV antrum than previously reported. This method may be a new way of pulmonary vein antrum isolation. Left atrial voltage mapping after PVI. Funding Acknowledgement Type of funding source: None


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