Visually guided laser ablation for atrial fibrillation: First experience in Greece

Visually guided laser ablation for atrial fibrillation: First experience in Greece Interventional treatment for symptomatic paroxysmal atrial fibrillation (pAF) has been incorporated in practice guidelines. 1 Following the gold standard radiofrequency (RF) ablation for pulmonary vein isolation (PVI), balloon-based treatments have been developed.2e5 The HeartLight Endoscopic Ablation System (Heart-Light; CardioFocus, MA, USA) utilizes a compliant balloon equipped with a laser beam and a small endoscope.5 Indeed, recently, fiveyear outcomes (90 patients, mean age 60 years, 37% females) of this novel approach became available showing a favorable safety profile both as a single treatment or combined with RF redo procedure.6 In the present article, we describe the first two patients treated in Greece with LB ablation.Two patients, with otherwise unremarkable medical history, were referred to our department for PVI for pAF.The procedure was guided by fluoroscopy and endoscopic data (Fig. 1), and no additional imaging modalities were utilized.The last NOAC dose was administered 12-24 hours prior to intervention (and reinitiated 4-6 hours after).Double puncture of both femoral veins was conducted.Through the left, diagnostic catheters were advanced and positioned in the right ventricular apex and coronary sinus.The right femoral vein was utilized for two consecutive punctures of the interatrial septum.Transseptal punctures were conducted consecutively via 8 Fr transeptal sheathes.The first transseptal sheath was exchanged over a guidewire for a steerable sheath (inner/outer diameter ¼ 12 Fr/18 Fr).Next, a second transseptal puncture was conducted.Immediately afterwards, intravenous heparin was administered