Key result
Second-generation laser balloons achieved similar initial pulmonary vein isolation rates as first-generation (89% vs 93%, P=0.360) but enabled more zero rotational maneuvers (20% vs 7%, P=0.007).
Why the study?
Procedural data of pulmonary vein isolation for atrial fibrillation using the recently available second-generation laser balloon remained unclear.
Does the second-generation laser balloon improve procedural characteristics compared to the first-generation laser balloon in patients undergoing pulmonary vein isolation for atrial fibrillation?
Cohort (n=60)
Does the second-generation laser balloon improve procedural characteristics compared to the first-generation laser balloon in patients undergoing pulmonary vein isolation for atrial fibrillation?
Absolute Event Rate: 89% vs 93%
p-value: p=0.360
The second-generation laser balloon provides better pulmonary vein occlusion and enables more zero rotational maneuvers compared to the first-generation device, without increasing procedural time or complications.
LB2 may enable greater antral isolation than LB1; leaves open impact on AF recurrence.
BACKGROUND: The procedural data of pulmonary vein (PV) isolation (PVI) for patients with atrial fibrillation using the second-generation laser balloon (LB2), which became available recently, remains unclear and were evaluated. METHODS: Thirty consecutive patients (116 PVs) underwent PVI using LB2 (LB2 group) and were matched to 30 patients (116 PVs) treated with the first-generation laser balloon (LB1 group). The left atrial isolated surface area (ISA) (ratio of the total isolated antral surface area excluding PV to the total isolated antral surface area including the posterior wall) was also measured after LB2 PVI. RESULTS: PVI was achieved in 103/116 (89%) PVs and 108/116 (93%) PVs in the LB2 and LB1 groups, respectively, after the initial circular ablation (P = 0.360) and in 115/116 (99%) PVs and 116/116 (100%) PVs in the LB2 and LB1 groups, respectively, at the end of the procedure (P = 1.000). PV occlusion grade, categorized by the degree of PV occlusion, was significantly better in the LB2 group than in the LB1 group (P < 0.001). Zero rotational maneuver was applicable in 23/116 (20%) PVs and 8/116 (7%) in the LB2 and LB1 groups, respectively (P = 0.007). There was no significant difference in the procedural time, fluoroscopic time, or complications. The mean ISA after LB2 PVI was 53 ± 14%. The application number was the only independent predictor of successful PVI after initial circular LB2 ablation (adjusted odds ratio 0.860; 95% confidence interval 0.764-0.968; P = 0.013). CONCLUSION: LB2 displays favorable PV occlusion characteristics and enables more zero rotational maneuvers.
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Nagase et al. (2019) conducted a cohort in Atrial fibrillation (n=60). Second-generation laser balloon (LB2) vs. First-generation laser balloon (LB1) was evaluated on Pulmonary vein isolation achieved after initial circular ablation (p=0.360). Second-generation laser balloons achieved similar initial pulmonary vein isolation rates as first-generation (89% vs 93%, P=0.360) but enabled more zero rotational maneuvers (20% vs 7%, P=0.007).
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