Anatomical-guided third-generation laser balloon ablation for the treatment of paroxysmal atrial fibrillation assessed by continuous rhythm monitoring: results from a multicentre prospective study

Figures

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  Figure 1. This figure demonstrates the LB ablation technique with rapid modality for circumferential PVI, comparing different approaches based on varying levels of contact with the PV antrum. (Left panels) The target is the RSPV. Top panels: the LB correctly occludes the RSPV, with the blind spot free, making single-sweep ablation feasible. The laser beam navigates through the blind spot, allowing for complete circumferential isolation. Bottom diagrams: schematic representation of the laser ablation process for the RSPV. The accurate evaluation confirms the laser beam’s entry and exit from the blind spot, ensuring successful circumferential isolation (contiguous circumferential laser delivery around the PV antrum using RAPID mode; solid green line). (Right panels) The target is the LIPV. Top panels: initial assessment of LB occlusion shows poor catheter-to-vein coaxiality due to the vein's anatomy, creating challenges from potential blood contact with the laser beam. Balloon rotation exposes the target area, enabling a two-step RAPID mode laser delivery for a complete circumferential lesion. Bottom diagrams: the double-step RAPID mode is employed to achieve complete circumferential…

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  Figure 2. Proportion of patients with and without any atrial tachyarrhythmias (ATa) at implanted device interrogation and different arrhythmic burden cut-off (0, <5, and ≥5%) at 12-, 24-, and 36-month follow-up in the four centres.

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  Figure 3. Time to first atrial tachyarrhythmias (ATa) episode. Kaplan–Meier survival curves for any ATa recurrences after a 3-month blanking period in patients with or without variables significantly associated with an increased risk of arrhythmic recurrence. (A) Different survival curves between patients with or without arrhythmic recurrences during the blanking period. (B) Different survival curves between patients with or without moderate left atrium (LA) enlargement.