SPC365

Portuguese initial experience of atrial fibrillation ablation using LASER balloon

Session: Posters - C. Arrhythmias and Device Therapy
Speaker: Pedro Carmo

Congress: CPC 2021
Topic: C. Arrhythmias and Device Therapy
Theme: 05. Atrial Fibrillation
Subtheme: 05.4 Atrial Fibrillation - Treatment
Session Type: Posters
FP Number: ---
Authors: Pedro Lopes Do Carmo; Francisco Morgado; Gustavo Rodrigues; Diogo Cavaco; Francisco Costa; João Carmo; Pedro Santos; Ricardo Bernardo; Pedro Adragão; Miguel Mendes
<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif"><span style="color:#212121">Introduction:</span></span></strong><strong>&nbsp;</strong></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="color:#212121"><span style="background-color:white">Durable isolation of the pulmonary veins (PVs) remains the cornerstone of atrial fibrillation (AF) ablation.</span></span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="color:#212121"><span style="background-color:white">Endoscopic laser balloon ablation (ELBA) has been proven to be safe and effective as a treatment for AF. The acute PV reconnection rate is significantly less after ELBA than after radiofrequency and has high levels of durable PVI.</span></span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="color:#212121">This is the report of the initial Portuguese experience with the ELBA in terms of procedural characteristics.</span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif"><span style="color:#212121">Methods:</span></span></strong><strong>&nbsp;</strong></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><span style="color:#212121">Twelve patients (eight male, age 62<span style="background-color:white">&plusmn;11 years</span>) with paroxysmal and persistent drug-refractory AF underwent ELBA PVI in our center, between September and December 2020. Two patients had past history of PVI procedure. </span></span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif"><span style="color:#212121">Results:</span></span></strong><strong>&nbsp;</strong></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><span style="color:#212121">Double transeptal puncture was performed in all cases. We used a circular catheter to confirm PV bidirectional block and Heart Light X3 system (CardioFocus Inc.) to ablate. </span></span></span></span></span><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><span style="color:#212121">The laser beam was guide by direct visualization of the PVI ostia using an endoscopy catheter inside the balloon. An esophageal temperature probe was used in all cases. </span></span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><span style="color:#212121">Mean procedure time was 118 min and mean fluoroscopy time was 20 min. 96 % of the PV were successfully isolated with the ELBA. No acute reconnection was reported. </span></span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><span style="color:#212121">One procedure was complicated by a temporary phrenic nerve palsy. No other acute complications occurred. </span></span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif"><span style="color:#212121">Conclusion:</span></span></strong><strong>&nbsp;</strong></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><span style="color:#212121">PVI with ELBA was associated with a low risk of complications and a high rate of acute success. &nbsp;Catheter manipulation is straightforward with a fast-learning curve.&nbsp;</span></span></span></span></span></p>