Cargando…
Evaluation of different ablation strategies verifying the optimal overlap ratio in point-by-point laser balloon ablation for patients with atrial fibrillation
BACKGROUND: Optimal overlap ratio remains unclear in point-by-point laser balloon (LB) ablation. OBJECTIVE: This study sought to determine the optimal overlap strategy with target energies on the acute and chronic outcomes in LB pulmonary vein (PV) isolation (PVI). METHODS: Consecutive 38 patients (...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369302/ https://www.ncbi.nlm.nih.gov/pubmed/34430940 http://dx.doi.org/10.1016/j.hroo.2021.06.007 |
_version_ | 1783739264324861952 |
---|---|
author | Nagase, Takahiko Seki, Ruiko Asano, So Fukunaga, Hiroshi Terashima, Kazuhiro Mabuchi, Kei Inoue, Kanki Tanizaki, Kohei Iguchi, Nobuo Nitta, Junichi Isobe, Mitsuaki |
author_facet | Nagase, Takahiko Seki, Ruiko Asano, So Fukunaga, Hiroshi Terashima, Kazuhiro Mabuchi, Kei Inoue, Kanki Tanizaki, Kohei Iguchi, Nobuo Nitta, Junichi Isobe, Mitsuaki |
author_sort | Nagase, Takahiko |
collection | PubMed |
description | BACKGROUND: Optimal overlap ratio remains unclear in point-by-point laser balloon (LB) ablation. OBJECTIVE: This study sought to determine the optimal overlap strategy with target energies on the acute and chronic outcomes in LB pulmonary vein (PV) isolation (PVI). METHODS: Consecutive 38 patients (148 PVs) with atrial fibrillation underwent the first-generation LB PVI with the following protocols based on the overlap ratios for each PV anterior/posterior wall: 50%/50% (13 patients [49 PVs], group A), 50%/25% (15 patients [60 PVs], group B), and 25%/25% (10 patients [39 PVs], group C). High energies (240–255 J: 12 W / 20 seconds, 8.5 W / 30 seconds), moderate energies (200–210 J: 10 W / 20 seconds, 7 W / 30 seconds), and low-to-moderate energies (low, 165–170 J: 5.5 W / 30 seconds, 8.5 W / 20 seconds) were targeted for left PV anterior walls, right PV anterior walls, and bilateral PV posterior walls, respectively. First-pass PVI, the other procedure-related data, and atrial tachyarrhythmia recurrences were analyzed. RESULTS: First-pass PVI rate per PV was higher in group A (94%) than in group B (88%) and group C (62%) (P < .001). All PVs were finally isolated. First-pass time, total LB PVI time, complications, and atrial tachyarrhythmia recurrences during a mean follow-up of 11 ± 5 months did not differ between the groups. A few residual gaps after first-pass LB ablations were found for PV anterior walls even in group A and group B. CONCLUSION: Sufficiently overlapped LB ablation promises a high rate of first-pass PVI without adverse outcomes. High energy could be required for PV anterior walls. |
format | Online Article Text |
id | pubmed-8369302 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-83693022021-08-23 Evaluation of different ablation strategies verifying the optimal overlap ratio in point-by-point laser balloon ablation for patients with atrial fibrillation Nagase, Takahiko Seki, Ruiko Asano, So Fukunaga, Hiroshi Terashima, Kazuhiro Mabuchi, Kei Inoue, Kanki Tanizaki, Kohei Iguchi, Nobuo Nitta, Junichi Isobe, Mitsuaki Heart Rhythm O2 Clinical BACKGROUND: Optimal overlap ratio remains unclear in point-by-point laser balloon (LB) ablation. OBJECTIVE: This study sought to determine the optimal overlap strategy with target energies on the acute and chronic outcomes in LB pulmonary vein (PV) isolation (PVI). METHODS: Consecutive 38 patients (148 PVs) with atrial fibrillation underwent the first-generation LB PVI with the following protocols based on the overlap ratios for each PV anterior/posterior wall: 50%/50% (13 patients [49 PVs], group A), 50%/25% (15 patients [60 PVs], group B), and 25%/25% (10 patients [39 PVs], group C). High energies (240–255 J: 12 W / 20 seconds, 8.5 W / 30 seconds), moderate energies (200–210 J: 10 W / 20 seconds, 7 W / 30 seconds), and low-to-moderate energies (low, 165–170 J: 5.5 W / 30 seconds, 8.5 W / 20 seconds) were targeted for left PV anterior walls, right PV anterior walls, and bilateral PV posterior walls, respectively. First-pass PVI, the other procedure-related data, and atrial tachyarrhythmia recurrences were analyzed. RESULTS: First-pass PVI rate per PV was higher in group A (94%) than in group B (88%) and group C (62%) (P < .001). All PVs were finally isolated. First-pass time, total LB PVI time, complications, and atrial tachyarrhythmia recurrences during a mean follow-up of 11 ± 5 months did not differ between the groups. A few residual gaps after first-pass LB ablations were found for PV anterior walls even in group A and group B. CONCLUSION: Sufficiently overlapped LB ablation promises a high rate of first-pass PVI without adverse outcomes. High energy could be required for PV anterior walls. Elsevier 2021-07-02 /pmc/articles/PMC8369302/ /pubmed/34430940 http://dx.doi.org/10.1016/j.hroo.2021.06.007 Text en © 2021 Heart Rhythm Society. Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Nagase, Takahiko Seki, Ruiko Asano, So Fukunaga, Hiroshi Terashima, Kazuhiro Mabuchi, Kei Inoue, Kanki Tanizaki, Kohei Iguchi, Nobuo Nitta, Junichi Isobe, Mitsuaki Evaluation of different ablation strategies verifying the optimal overlap ratio in point-by-point laser balloon ablation for patients with atrial fibrillation |
title | Evaluation of different ablation strategies verifying the optimal overlap ratio in point-by-point laser balloon ablation for patients with atrial fibrillation |
title_full | Evaluation of different ablation strategies verifying the optimal overlap ratio in point-by-point laser balloon ablation for patients with atrial fibrillation |
title_fullStr | Evaluation of different ablation strategies verifying the optimal overlap ratio in point-by-point laser balloon ablation for patients with atrial fibrillation |
title_full_unstemmed | Evaluation of different ablation strategies verifying the optimal overlap ratio in point-by-point laser balloon ablation for patients with atrial fibrillation |
title_short | Evaluation of different ablation strategies verifying the optimal overlap ratio in point-by-point laser balloon ablation for patients with atrial fibrillation |
title_sort | evaluation of different ablation strategies verifying the optimal overlap ratio in point-by-point laser balloon ablation for patients with atrial fibrillation |
topic | Clinical |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369302/ https://www.ncbi.nlm.nih.gov/pubmed/34430940 http://dx.doi.org/10.1016/j.hroo.2021.06.007 |
work_keys_str_mv | AT nagasetakahiko evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation AT sekiruiko evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation AT asanoso evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation AT fukunagahiroshi evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation AT terashimakazuhiro evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation AT mabuchikei evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation AT inouekanki evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation AT tanizakikohei evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation AT iguchinobuo evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation AT nittajunichi evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation AT isobemitsuaki evaluationofdifferentablationstrategiesverifyingtheoptimaloverlapratioinpointbypointlaserballoonablationforpatientswithatrialfibrillation |