Martín R Arceluz1, Pedro F Cruz2, Estela Falconi2, Rosa Montes de Oca2, Reina Delgado2, Jorge Figueroa2, Marta Ortega2, José L Merino3. 1. Arrhythmias and Electrophysiology Robotic Unit, La Paz University Hospital, P. de la Castellana 261, 28046, Madrid, Spain. martin_arceluz@hotmail.com. 2. Arrhythmias and Electrophysiology Robotic Unit, La Paz University Hospital, P. de la Castellana 261, 28046, Madrid, Spain. 3. Arrhythmias and Electrophysiology Robotic Unit, La Paz University Hospital, P. de la Castellana 261, 28046, Madrid, Spain. jlmerino@arritmias.net.
Abstract
PURPOSE: The aim of the present study is to evaluate the feasibility and safety of SVC electrical isolation by LB ablation in patients with atrial fibrillation (AF) referred for pulmonary vein isolation (PVI). METHODS: Electrical disconnection of the SVC was attempted by LB in 13 consecutive patients (59 ± 10.5 years, 11 male) with AF following PVI. PVI was successfully achieved by standard LB in all before attempting SVC isolation. RESULTS: A laser beam was delivered with 6.3 ± 2.3 W and 8.4 ± 2.7 W (P = 0.001) during 5.38 ± 2.4 min and 9.75 ± 1.6 min (P = 0.024) to achieve SVC and PV, respectively. Isolation of the SVC by LB was accomplished in 8 patients (61%) without complications. Phrenic nerve palsy developed in 3 patients (23%), which resulted in early procedure termination before isolation. Technical problems or interposition of a pacemaker lead to prevented SVC isolation in the remaining 2 patients. After a mean follow-up of 19 ± 3 months, no patient recovered from phrenic nerve palsy. CONCLUSIONS: SVC isolation by LB is feasible but associated with a high risk of phrenic nerve palsy. Limitation of laser delivery time and power appears insufficient to prevent this complication.
PURPOSE: The aim of the present study is to evaluate the feasibility and safety of SVC electrical isolation by LB ablation in patients with atrial fibrillation (AF) referred for pulmonary vein isolation (PVI). METHODS: Electrical disconnection of the SVC was attempted by LB in 13 consecutive patients (59 ± 10.5 years, 11 male) with AF following PVI. PVI was successfully achieved by standard LB in all before attempting SVC isolation. RESULTS: A laser beam was delivered with 6.3 ± 2.3 W and 8.4 ± 2.7 W (P = 0.001) during 5.38 ± 2.4 min and 9.75 ± 1.6 min (P = 0.024) to achieve SVC and PV, respectively. Isolation of the SVC by LB was accomplished in 8 patients (61%) without complications. Phrenic nerve palsy developed in 3 patients (23%), which resulted in early procedure termination before isolation. Technical problems or interposition of a pacemaker lead to prevented SVC isolation in the remaining 2 patients. After a mean follow-up of 19 ± 3 months, no patient recovered from phrenic nerve palsy. CONCLUSIONS: SVC isolation by LB is feasible but associated with a high risk of phrenic nerve palsy. Limitation of laser delivery time and power appears insufficient to prevent this complication.
Authors: Michel Haïssaguerre; Mélèze Hocini; Prashanthan Sanders; Frederic Sacher; Martin Rotter; Yoshihide Takahashi; Thomas Rostock; Li-Fern Hsu; Pierre Bordachar; Sylvain Reuter; Raymond Roudaut; Jacques Clémenty; Pierre Jaïs Journal: J Cardiovasc Electrophysiol Date: 2005-11
Authors: Markus Linhart; Annika Nielson; René P Andrié; Erica L Mittmann-Braun; Florian Stöckigt; Jens Kreuz; Georg Nickenig; Jan W Schrickel; Lars M Lickfett Journal: J Cardiovasc Electrophysiol Date: 2014-05-18
Authors: Jose L Merino; Rafael Peinado; Mauricio Abello; Mariana Gnoatto; Mar G Vasserot; Jose A Sobrino Journal: J Cardiovasc Electrophysiol Date: 2005-06
Authors: Pipin Kojodjojo; Mark D O'Neill; Phang Boon Lim; Louisa Malcolm-Lawes; Zachary I Whinnett; Tushar V Salukhe; Nicholas W Linton; David Lefroy; Anthony Mason; Ian Wright; Nicholas S Peters; Prapa Kanagaratnam; D Wyn Davies Journal: Heart Date: 2010-09 Impact factor: 5.994
Authors: Chadi Dib; Suraj Kapa; Brian D Powell; Douglas L Packer; Samuel J Asirvatham Journal: J Interv Card Electrophysiol Date: 2008-03-07 Impact factor: 1.900