Skip to main content
Top
Published in: Netherlands Heart Journal 2/2015

Open Access 01-02-2015 | Original Article

First Dutch experience with the endoscopic laser balloon ablation system for the treatment of atrial fibrillation

Authors: P. Gal, J. J. J. Smit, A. Adiyaman, A. R. Ramdat Misier, P. P. H. M. Delnoy, A. Elvan

Published in: Netherlands Heart Journal | Issue 2/2015

Login to get access

Abstract

Introduction

The endoscopic laser balloon ablation system (EAS) is a relatively novel technique to perform pulmonary vein isolation (PVI) in the treatment of atrial fibrillation (AF). The present study aimed to report the results of the first 50 patients treated in the Netherlands with the EAS in terms of procedural characteristics and AF-free survival.

Methods

Fifty patients successfully underwent EAS PVI. Median follow-up was 17 months. Mean age was 56 years, 82 % had paroxysmal AF.

Results

99 % of the pulmonary veins were successfully isolated with the EAS. Mean procedure time was 171 min and mean fluoroscopy time was 36 min. One procedure was complicated by a temporary phrenic nerve palsy (2 %). During follow-up, 58 % of patients remained free of AF without the use of antiarrhythmic drugs.

Conclusion

PVI with EAS is associated with a low risk of complications and a medium-term AF-free survival comparable with other PVI techniques.
Appendix
Available only for authorised users
Literature
1.
go back to reference Calkins H, Kuck KH, Cappato R, et al. HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace. 2012;14:528–606.PubMedCrossRef Calkins H, Kuck KH, Cappato R, et al. HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace. 2012;14:528–606.PubMedCrossRef
2.
go back to reference Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. New Engl J Med. 1998;339:659–66.PubMedCrossRef Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. New Engl J Med. 1998;339:659–66.PubMedCrossRef
3.
go back to reference Calkins H, Reynolds MR, Spector P, et al. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circ Arrhythm Electrophysiol. 2009;2:349–61.PubMedCrossRef Calkins H, Reynolds MR, Spector P, et al. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circ Arrhythm Electrophysiol. 2009;2:349–61.PubMedCrossRef
4.
go back to reference Van Belle Y, Janse P, Rivero-Ayerza MJ, et al. Pulmonary vein isolation using an occluding cryoballoon for circumferential ablation: feasibility, complications, and short-term outcome. Eur Heart J. 2007;28:2231–7.PubMedCrossRef Van Belle Y, Janse P, Rivero-Ayerza MJ, et al. Pulmonary vein isolation using an occluding cryoballoon for circumferential ablation: feasibility, complications, and short-term outcome. Eur Heart J. 2007;28:2231–7.PubMedCrossRef
5.
go back to reference Yokoyama K, Nakagawa H, Shah DC, et al. Novel contact force sensor incorporated in irrigated radiofrequency ablation catheter predicts lesion size and incidence of steam pop and thrombus. Circ Arrhythm Electrophysiol. 2008;1:354–62.PubMedCrossRef Yokoyama K, Nakagawa H, Shah DC, et al. Novel contact force sensor incorporated in irrigated radiofrequency ablation catheter predicts lesion size and incidence of steam pop and thrombus. Circ Arrhythm Electrophysiol. 2008;1:354–62.PubMedCrossRef
6.
go back to reference Reddy VY, Neuzil P, d’Avila A, et al. Balloon catheter ablation to treat paroxysmal atrial fibrillation: what is the level of pulmonary venous isolation? Heart Rhythm. 2008;5:353–60.PubMedCrossRef Reddy VY, Neuzil P, d’Avila A, et al. Balloon catheter ablation to treat paroxysmal atrial fibrillation: what is the level of pulmonary venous isolation? Heart Rhythm. 2008;5:353–60.PubMedCrossRef
7.
go back to reference Reddy VY, Neuzil P, Themistoclakis S, et al. Visually-guided balloon catheter ablation of atrial fibrillation: experimental feasibility and first-in-human multicenter clinical outcome. Circulation. 2009;120:12–20.PubMedCrossRef Reddy VY, Neuzil P, Themistoclakis S, et al. Visually-guided balloon catheter ablation of atrial fibrillation: experimental feasibility and first-in-human multicenter clinical outcome. Circulation. 2009;120:12–20.PubMedCrossRef
8.
go back to reference Dukkipati SR, Neuzil P, Skoda J, et al. Visual balloon-guided point-by-point ablation: reliable, reproducible, and persistent pulmonary vein isolation. Circ Arrhythm Electrophysiol. 2010;3:266–73.PubMedCrossRef Dukkipati SR, Neuzil P, Skoda J, et al. Visual balloon-guided point-by-point ablation: reliable, reproducible, and persistent pulmonary vein isolation. Circ Arrhythm Electrophysiol. 2010;3:266–73.PubMedCrossRef
9.
go back to reference Dukkipati SR, Kuck KH, Neuzil P, et al. Pulmonary vein isolation using a visually guided laser balloon catheter: the first 200-patient multicenter clinical experience. Circ Arrhythm Electrophysiol. 2013;6:467–72.PubMedCrossRef Dukkipati SR, Kuck KH, Neuzil P, et al. Pulmonary vein isolation using a visually guided laser balloon catheter: the first 200-patient multicenter clinical experience. Circ Arrhythm Electrophysiol. 2013;6:467–72.PubMedCrossRef
10.
go back to reference Dukkipati SR, Neuzil P, Kautzner J, et al. The durability of pulmonary vein isolation using the visually guided laser balloon catheter: multicenter results of pulmonary vein remapping studies. Heart Rhythm. 2012;9:919–25.PubMedCrossRef Dukkipati SR, Neuzil P, Kautzner J, et al. The durability of pulmonary vein isolation using the visually guided laser balloon catheter: multicenter results of pulmonary vein remapping studies. Heart Rhythm. 2012;9:919–25.PubMedCrossRef
11.
go back to reference Schmidt B, Metzner A, Chun KR, et al. Feasibility of circumferential pulmonary vein isolation using a novel endoscopic ablation system. Circ Arrhythm Electrophysiol. 2010;3:481–8.PubMedCrossRef Schmidt B, Metzner A, Chun KR, et al. Feasibility of circumferential pulmonary vein isolation using a novel endoscopic ablation system. Circ Arrhythm Electrophysiol. 2010;3:481–8.PubMedCrossRef
13.
go back to reference Cappato R, Negroni S, Pecora D, et al. Prospective assessment of late conduction recurrence across radiofrequency lesions producing electrical disconnection at the pulmonary vein ostium in patients with atrial fibrillation. Circulation. 2003;108:1599–604.PubMedCrossRef Cappato R, Negroni S, Pecora D, et al. Prospective assessment of late conduction recurrence across radiofrequency lesions producing electrical disconnection at the pulmonary vein ostium in patients with atrial fibrillation. Circulation. 2003;108:1599–604.PubMedCrossRef
14.
go back to reference Lemola K, Hall B, Cheung P, et al. Mechanisms of recurrent atrial fibrillation after pulmonary vein isolation by segmental ostial ablation. Heart Rhythm. 2004;1:197–202.PubMedCrossRef Lemola K, Hall B, Cheung P, et al. Mechanisms of recurrent atrial fibrillation after pulmonary vein isolation by segmental ostial ablation. Heart Rhythm. 2004;1:197–202.PubMedCrossRef
15.
go back to reference Bordignon S, Chun KR, Gunawardene M, et al. Energy titration strategies with the endoscopic ablation system: lessons from the high-dose vs. low-dose laser ablation study. Europace. 2013;15:685–9.PubMedCrossRef Bordignon S, Chun KR, Gunawardene M, et al. Energy titration strategies with the endoscopic ablation system: lessons from the high-dose vs. low-dose laser ablation study. Europace. 2013;15:685–9.PubMedCrossRef
Metadata
Title
First Dutch experience with the endoscopic laser balloon ablation system for the treatment of atrial fibrillation
Authors
P. Gal
J. J. J. Smit
A. Adiyaman
A. R. Ramdat Misier
P. P. H. M. Delnoy
A. Elvan
Publication date
01-02-2015
Publisher
Bohn Stafleu van Loghum
Published in
Netherlands Heart Journal / Issue 2/2015
Print ISSN: 1568-5888
Electronic ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-014-0624-y

Other articles of this Issue 2/2015

Netherlands Heart Journal 2/2015 Go to the issue