scholarly journals Second-Generation Visually Guided Laser Balloon Ablation System for Pulmonary Vein Isolation: Learning Curve, Safety and Efficacy　― The MERLIN Registry ―

2019 ◽  
Vol 83 (12) ◽  
pp. 2443-2451 ◽  
Author(s):  
Christian-H. Heeger ◽  
Huong-Lan Phan ◽  
Roza Meyer-Saraei ◽  
Thomas Fink ◽  
Vanessa Sciacca ◽  
...  
Keyword(s):  
Learning Curve ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Second Generation ◽  
Visually Guided ◽  
Safety And Efficacy ◽  
Balloon Ablation ◽  
Laser Balloon Ablation ◽  
Laser Balloon

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 ◽  
...  
Keyword(s):  
Learning Curve ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Fluoroscopy Time ◽  
Visually Guided ◽  
Procedure Time ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Balloon Ablation ◽  
Laser Balloon

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.

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 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 Quantitative analysis of the isolation area after larger-size laser balloon ablation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Yamasaki ◽  
T Hattori ◽  
K Kakita ◽  
K Oota ◽  
N Miyai ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Balloon Catheter ◽  
Posterior Wall ◽  
Maximum Pressure ◽  
Cryoballoon Ablation ◽  
Visually Guided ◽  
Balloon Ablation ◽  
Laser Balloon Ablation ◽  
Pulmonary Vein Antrum Isolation ◽  
Laser Balloon

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

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 B-PO02-073 ONE-YEAR FOLLOW-UP AFTER WIDE-AREA PULMONARY VEIN ISOLATION USING THE VISUALLY GUIDED LASER BALLOON FOR ATRIAL FIBRILLATION

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
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Wide Area ◽  
Visually Guided ◽  
One Year ◽  
Laser Balloon
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