Clinical research in cardiology : official journal of the German Cardiac Society · 2017
Five-year clinical outcomes of visually guided laser balloon pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation.
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Reissmann Bruno, Budelmann Thorsten, Wissner Erik, Schlüter Michael, Heeger Christian-Hendrik, Mathew Shibu, Maurer Tilman, Lemes Christine, Fink Thomas, Rillig Andreas, Santoro Francesco, Riedl Johannes, Ouyang Feifan, Kuck Karl-Heinz, Metzner Andreas
Аннотация
BACKGROUND: Visually guided laser balloon (VGLB) ablation allows for pulmonary vein isolation (PVI) under direct endoscopic control. Short- and midterm clinical outcomes are in accordance with results of radiofrequency current (RFC) ablation for the treatment of paroxysmal atrial fibrillation (PAF).
OBJECTIVE: The current study sought to assess the long-term clinical outcomes of VGLB-based PVI for PAF.
METHODS: A total of 90 patients [60 ± 10 years; 33 (37%) female, left atrial diameter 42 ± 4 mm] with drug-refractory PAF underwent VGLB ablation. The median duration of PAF until VGLB ablation was 36 (interquartile range 12; 84) months. Follow-up was based on outpatient clinic visits including Holter ECGs and telephone interviews. Repeat ablation due to arrhythmia recurrences was performed using RFC ablation.
RESULTS: After a single VGLB procedure, 5-year freedom from arrhythmia recurrence was 51% [95% confidence interval (CI) 39-62%]. Thirty-three patients underwent repeat RFC ablation procedures, resulting in multiple procedure freedom from arrhythmia recurrence of 78% (95% CI 68-88%). Major periprocedural complications occurred in four patients (4%).
CONCLUSIONS: VGLB ablation for the treatment of drug-refractory PAF is safe and results in 5-year single and multiple procedure arrhythmia-free survival of 51 and 78%, respectively.
OBJECTIVE: The current study sought to assess the long-term clinical outcomes of VGLB-based PVI for PAF.
METHODS: A total of 90 patients [60 ± 10 years; 33 (37%) female, left atrial diameter 42 ± 4 mm] with drug-refractory PAF underwent VGLB ablation. The median duration of PAF until VGLB ablation was 36 (interquartile range 12; 84) months. Follow-up was based on outpatient clinic visits including Holter ECGs and telephone interviews. Repeat ablation due to arrhythmia recurrences was performed using RFC ablation.
RESULTS: After a single VGLB procedure, 5-year freedom from arrhythmia recurrence was 51% [95% confidence interval (CI) 39-62%]. Thirty-three patients underwent repeat RFC ablation procedures, resulting in multiple procedure freedom from arrhythmia recurrence of 78% (95% CI 68-88%). Major periprocedural complications occurred in four patients (4%).
CONCLUSIONS: VGLB ablation for the treatment of drug-refractory PAF is safe and results in 5-year single and multiple procedure arrhythmia-free survival of 51 and 78%, respectively.
Предметные рубрики MeSH
Action PotentialsAgedAtrial FibrillationCardiac CathetersCatheter AblationClinical CompetenceDisease-Free SurvivalElectrocardiography, AmbulatoryEndoscopesEndoscopyEquipment DesignFemaleHeart RateHumansLaser TherapyLearning CurveMaleMiddle AgedPulmonary VeinsRecurrenceReoperationRetrospective StudiesRisk FactorsTime FactorsTreatment Outcome