Key result
In patients undergoing visually guided laser ablation for paroxysmal AF, the presence of a left common pulmonary vein was associated with a shorter ablation procedure time (61.5 vs 86.9 min, p=0.01).
Why the study?
The clinical efficacy and procedural safety of visually guided laser ablation had not been fully investigated in patients with a left common pulmonary vein.
Does balloon-based visually guided laser ablation safely and effectively isolate pulmonary veins and prevent atrial tachyarrhythmia recurrence in patients with a left common pulmonary vein?
Cohort (n=130)
Does balloon-based visually guided laser ablation safely and effectively isolate pulmonary veins and prevent atrial tachyarrhythmia recurrence in patients with a left common pulmonary vein?
Answers are grounded in this paper and cite their sources.
May shorten laser ablation times in variant anatomy; leaves open impact on outcomes and need for confirmation.
Background: Pulmonary vein isolation (PVI) with a balloon-based visually guided laser ablation (VGLA) is regarded as a useful therapeutic tool for treating atrial fibrillation (AF). The clinical efficacy of a VGLA has never been fully investigated in patients with a left common pulmonary vein (LCPV). Objective: We investigated the procedural safety as well as clinical usefulness of VGLA in patients with an LCPV. Methods: This study consisted of 130 consecutive patients who underwent VGLA of de novo non-valvular paroxysmal AF. Results: Eleven patients (8.5%) had an LCPV (ostium maximal average diameter: 27.5 ± 4.9 mm, ostium minimal average diameter: 17.7 ± 3.5 mm). Nine out of 11 (81.8%) LCPVs were successfully occluded and isolated at the ostium with a VGLA guided PVI. The ablation procedure time was significantly shorter in the patients with than without an LCPV (61.5 ± 15.4 vs. 86.9 ± 32.9 min, p = 0.01). There was no difference regarding the atrial tachyarrhythmia recurrence between those with and without an LCPV (p = 0.18). A total of fifteen patients underwent a redo procedure, but reconnections were not observed in any of the LCPV patients. Conclusion: The VGLA guided PVI was a useful therapeutic tool even in patients with an LCPV. The presence of an LCPV was not associated with any atrial tachyarrhythmia recurrence.
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Tachibana et al. (2021) conducted a cohort in De novo non-valvular paroxysmal atrial fibrillation (n=130). Presence of a left common pulmonary vein (LCPV) vs. Absence of a left common pulmonary vein was evaluated on Ablation procedure time (minutes) (p=0.01). In patients undergoing visually guided laser ablation for paroxysmal AF, the presence of a left common pulmonary vein was associated with a shorter ablation procedure time (61.5 vs 86.9 min, p=0.01).
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