Key result
Laser balloon PVI achieves 100% acute first-pass isolation without complications in prior LAAO patients.
Why the study?
The feasibility and safety of laser balloon pulmonary vein isolation in patients with prior left atrial appendage occlusion device implantation were not established.
Does laser balloon pulmonary vein isolation prevent periprocedural complications and AF recurrence in patients with prior left atrial appendage occlusion?
Observational
No
Does laser balloon pulmonary vein isolation prevent periprocedural complications and AF recurrence in patients with prior left atrial appendage occlusion?
Laser balloon pulmonary vein isolation is feasible and safe in patients with prior left atrial appendage occlusion devices, achieving 100% acute isolation without periprocedural complications.
Supports feasibility of laser balloon PVI post-LAAO; hypothesis-generating and requires prospective trials before wider adoption.
INTRODUCTION: With the increasing adoption of left atrial appendage occlusion (LAAO) procedures and the eligibility of patients for pulmonary vein isolation (PVI) post device placement, we examined the feasibility and safety of laser balloon (LB) for PVI in patients with prior LAAO. METHODS: We retrospectively examined consecutive patients with paroxysmal or persistent, drug-resistant atrial fibrillation (AF) who underwent LB PVI, after Watchman FLX device implantation at Rush University Medical Center between January 2020 and December 2021. RESULTS: VASc is 2.6 ± 0.5 and the mean HAS-BLED score is 3.4 ± 0.8. The mean follow-up duration was 10 ± 7 months. The mean duration between Watchman FLX device implantation and LB PVI was 592 days. Acute first pass left pulmonary vein (PV) isolation was achieved in 100% of the procedures. There were no periprocedural complications such as death, pericardial tamponade or effusion, phrenic nerve injury, PV stenosis, device perforation or embolization, or worsening peri-device leak in any of the patients. None of the patients had AF recurrence after the blanking period. CONCLUSION: LB PVI was safe and effective with 100% acute isolation of left-sided veins in patients with prior LAAO device.
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Khalil et al. (2022) conducted an observational in Paroxysmal or persistent, drug-resistant atrial fibrillation. Laser balloon pulmonary vein isolation was evaluated on Acute first pass left pulmonary vein isolation. Laser balloon pulmonary vein isolation achieved 100% acute first pass left pulmonary vein isolation with no periprocedural complications in patients with prior left atrial appendage occlusion.
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