Effectiveness of a manual dragging laser irradiation technique using the first‐generation endoscopic laser balloon ablation system for pulmonary vein isolation

Background Although high efficacy of laser balloon (LB) ablation for atrial fibrillation (AF) has been shown, the conventional point‐by‐point technique requires a long procedure time. We investigated the clinical effectiveness of the manual dragging laser technique. Methods We enrolled 51 consecutive patients with paroxysmal AF who underwent pulmonary vein isolation (PVI) using first‐generation LB (LB1) at our institution. The first 25 patients underwent PVI using a point‐by‐point laser irradiation maneuver (point‐by‐point group). The latter 26 patients underwent PVI using a manually dragging laser irradiation maneuver (dragging group). The power and delivery time for the laser energy were selected from a preset protocol with 5.5–12 W and 20–30 s for each application. The dragging irradiation method was performed by manually rotating approximately 1.5°/s during one irradiation application. Results PVI was successful in all cases. The duration of PVI was shorter (66 ± 20 vs. 116 ± 39 min, p < 0.0001), and the number of laser irradiations for the 4PVs were significantly less in the dragging group. There were four recurrent cases (16%) in the point‐by‐point group and 1 (4%) in the dragging group. There was no significant difference in the survival rate free from recurrence after the blanking period between the two groups (log‐rank p = 0.1570). The complications were similar between the groups (4% vs. 4%, ns). Conclusions The manual dragging laser irradiation technique using LB1 could shorten the PVI procedure time while preserving clinical effectiveness.