BACKGROUND: Pulmonary vein isolation (PVI) is an established treatment option for patients with drug refractory paroxysmal atrial fibrillation. A novel compliant endoscopic ablation system housing a 980-nm-diode laser allows for discrete point-by-point ablation enabling a true circumferential ablation line design. We sought to determine the feasibility and safety of a circumferential ablation using endoscopic ablation system. METHODS AND RESULTS: Thirty patients (17 female; mean age, 58±9 years) with a median paroxysmal atrial fibrillation history of 3 years (range, 1 to 17 years) were treated. PVI was achieved in 114 of 116 (98%) PVs (4 left common PVs), thereby achieving simultaneous PVI for separate ipsilateral PVs in 19 of 26 (73%) left PVs and 6 of 30 (20%) right PVs. The total procedure time was 250±62 minutes. Procedure time decreased from 310±59 to 220±37 minutes (P=0.0001) between the first 10 and the last 20 cases. Mean fluoroscopy time was 30±18 minutes. Twenty-seven patients underwent postoperative endoscopy showing no or minimal thermal lesions in the esophagus in 21 (78%) and 2 (7%), respectively. In 4 (15%) patients, an esophageal ulceration was found that healed without sequelae. One pericardial tamponade and 1 right-sided phrenic nerve palsy occurred. During a median follow-up of 168 days (113 to 203 days; q1-q3), 24 of 30 patients (80%) remained free of atrial fibrillation recurrence. CONCLUSIONS: Circumferential PVI using the novel compliant endoscopic ablation system was feasible in the majority of left PVs and minority of right PVs accompanied by a complication rate comparable to established approaches. To minimize the risk for thermal esophageal injury temperature monitoring is recommended.
BACKGROUND: Pulmonary vein isolation (PVI) is an established treatment option for patients with drug refractory paroxysmal atrial fibrillation. A novel compliant endoscopic ablation system housing a 980-nm-diode laser allows for discrete point-by-point ablation enabling a true circumferential ablation line design. We sought to determine the feasibility and safety of a circumferential ablation using endoscopic ablation system. METHODS AND RESULTS: Thirty patients (17 female; mean age, 58±9 years) with a median paroxysmal atrial fibrillation history of 3 years (range, 1 to 17 years) were treated. PVI was achieved in 114 of 116 (98%) PVs (4 left common PVs), thereby achieving simultaneous PVI for separate ipsilateral PVs in 19 of 26 (73%) left PVs and 6 of 30 (20%) right PVs. The total procedure time was 250±62 minutes. Procedure time decreased from 310±59 to 220±37 minutes (P=0.0001) between the first 10 and the last 20 cases. Mean fluoroscopy time was 30±18 minutes. Twenty-seven patients underwent postoperative endoscopy showing no or minimal thermal lesions in the esophagus in 21 (78%) and 2 (7%), respectively. In 4 (15%) patients, an esophageal ulceration was found that healed without sequelae. One pericardial tamponade and 1 right-sided phrenic nerve palsy occurred. During a median follow-up of 168 days (113 to 203 days; q1-q3), 24 of 30 patients (80%) remained free of atrial fibrillation recurrence. CONCLUSIONS: Circumferential PVI using the novel compliant endoscopic ablation system was feasible in the majority of left PVs and minority of right PVs accompanied by a complication rate comparable to established approaches. To minimize the risk for thermal esophageal injury temperature monitoring is recommended.
Authors: Martín R Arceluz; Pedro F Cruz; Estela Falconi; Rosa Montes de Oca; Reina Delgado; Jorge Figueroa; Marta Ortega; José L Merino Journal: J Interv Card Electrophysiol Date: 2018-05-07 Impact factor: 1.900
Authors: Irfan M Khurram; John N Catanzaro; Stefan Zimmerman; Vadim Zipunnikov; Ronald D Berger; Alan Cheng; Sunil Sinha; Jane Dewire; Joseph Marine; David Spragg; Hiroshi Ashikaga; Henry Halperin; Hugh Calkins; Saman Nazarian Journal: Pacing Clin Electrophysiol Date: 2015-08-17 Impact factor: 1.976
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Heart Rhythm Date: 2017-05-12 Impact factor: 6.343
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; José Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: Heart Rhythm Date: 2012-03-01 Impact factor: 6.343
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; Jose Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: J Interv Card Electrophysiol Date: 2012-03 Impact factor: 1.900
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Europace Date: 2018-01-01 Impact factor: 5.214