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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 (...

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Autores principales: Nagase, Takahiko, Seki, Ruiko, Asano, So, Fukunaga, Hiroshi, Terashima, Kazuhiro, Mabuchi, Kei, Inoue, Kanki, Tanizaki, Kohei, Iguchi, Nobuo, Nitta, Junichi, Isobe, Mitsuaki
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
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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.
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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
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