Abstract 1344 A single high volume centre experience with the first and second generation laser balloon ablation in pulmonary vein isolation for atrial fibrillation: Procedural data and long-term outcome.

Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
A single high volume centre experience with the first and second generation laser balloon ablation in pulmonary vein isolation for atrial fibrillation: Procedural data and long-term outcome.
L. Urbanek¹, S. Bordignon¹, S. Tohoku¹, F. Bologna¹, S. Chen¹, B. Schmidt¹, K. R. J. Chun¹
¹Medizinische Klinik III - CCB, Agaplesion Markus Krankenhaus, Frankfurt am Main;
Background: Visually guided laser balloon (LB)catheter pulmonary vein isolation (PVI) is an established ablation technique for atrial fibrillation. The purpose of this study was to evaluate the procedural data and chronic success in patients with symptomatic atrial fibrillation undergoing LB-PVI and to compare the first and second generation LB. Methods: Patients who underwent LB ablation with first or second generation LB for symptomatic AF were retrospectively enrolled and divided into two groups (first generation: LB1 and second generation: LB2). Procedural data, complications and success rate at one year were collected and compared among the two groups. All procedures were performed in conscious sedation. Procedural endpoint was electrical pulmonary vein isolation. Clinical success was defined as no recurrence of AF/atrial tachycardia (AT). Results: 538 patients were included (mean age was 66± 9,5; 57,8% with paroxysmal AF),427 in LB1 and 111 in LB2. Patient baseline characteristics were mainly comparable among the two groups. Procedural time (121±34 minutes and 99±22 minutes, p<0,001) and fluoroscopy time (11,2±5 minutes to 8,5±3 minutes, p<0,001) were significantly shorter with LB2. 2079 PVs were identified and 2073 (99,7%) were successfully isolated, of which 46 (2,2%) with additional touch up ablation. The overall freedom from AF after 1-year was 73,7%, For paroxysmal AF it was 76,8% and 70,0% in persistent AF (p<0,001). There was no difference in 1-year outcome between LB1 and LB2 for patients with paroxysmal (75,9% vs 81,1% p=0,76) or persistent (70,4% vs 68,8% p=0,32) AF. The overall complication rate was 8,7% (complication at access site: 2,6%, stroke or TIA: 1,1%, tamponade: 0,6%). For patients treated with LB1 it was 9,8% vs 4,5% in LB2 (p=0,076). Conclusion: Laser balloon ablation of atrial fibrillation showed a high efficacy and safety. The procedure time and fluoroscopy time was significantly shorter with second generation laser balloon. Overall 73,7% of patients were free of AF at one year, with comparable results among the two generation of LB.
https://dgk.org/kongress_programme/jt2022/aP1157.html