#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Initial experience using a laser-balloon endoscopic catheter for the treatment of patients with paroxysmal atrial fibrillation


Authors: J. Škoda 1;  P. Neužil 1;  V. Y. Reddy 2;  J. Petrů 1;  L. Šedivá 1;  M. Táborský 1;  A. Raviele 3;  S. Ernst 4;  K. H. Kuck 4;  A. Natale 5
Authors‘ workplace: Kardiologické oddělení Nemocnice Na Homolce, Praha 1;  Massachusetts General Hospital, Boston, USA 2;  Umberto Hospital, Venice, Itálie 3;  St. Georg Hospital, Hamburg, Německo 4;  Cleveland Foundation Hospital, Cleveland, USA 5
Published in: Prakt. Lék. 2007; 87(10): 618-623
Category: Of different specialties

Overview

Background:
During catheter ablation of atrial fibrillation (AF), placing contiguous point ablation lesions to electrically-isolate the pulmonary veins (PV) can be technically challenging. A novel balloon catheter (Endoscopic Ablation System – EAS; Cardiofocus, Inc.) which utilizes a miniature endoscope for real-time visualization during ablation has been developed. This system employs arcs of light-energy that are adjustable (rotating, advancing, retracting) independent of the balloon to direct energy to the pulmonary veins PV-left atrium(LA) region. This report details the first clinical long-term follow-up results from a prospective multicentric trial in patients from our center.

Methods:
22 patients with a history of symptomatic drug-resistant paroxysmal AF were studied: Sex: M/F = 19/3; Age 53 ± 8 years (29–73); AF duration: 7.0 ± 3.0 years (1–14); LA diameter: 42 ± 4 mm (33–49); left ventricular ejection fraction (LVEF) 68 ± 4% (45–77). A single treatment consisting of isolation of the PV ostia was delivered using the EAS. There were no exclusion criteria related to morphology/number of PVs

Results:
During long-term follow-up 17.1 ± 6.6 months (7–27) AF free endpoint was achieved in 19 (86.3%) patients, of whom 7 (33 %) patients needed adjunctive betablocker and/or propafenon. Three patients (13.6 %) experienced AF despite antiarrhythmic therapy, the procedure was successfully repeated in one patient. During 6 to 12 moths follow-up visits, a computed tomography revealed only mild stenosis 26.4 ± 4,4 % (20–37) in 16 % of PVs. Two adverse events were documented: transient ischemic attack, and pseudoaneurysm of a right femoral artery solved by a percutaneous glue-tissue application. The time of procedure + fluoroscopy significantly decreased during a learning curve.

Conclusion:
This initial clinical-feasibility study suggests that a single treatment with the EAS of paroxysmal AF appears safe and efficacious.

Key words:
paroxysmal atrial fibrillation, catheter ablation, transseptal puncture, pulmonary vein isolation, light-energy laser arc.


Labels
General practitioner for children and adolescents General practitioner for adults
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#