Wide area circumferential ablation for pulmonary vein isolation using radiofrequency versus laser balloon ablation

• DOI: 10.1002/joa3.12722
• Publication Date: 2022-05-07T05:59:18Z
• Authors: Jamario Skeete; Parikshit S. Sharma; David Kenigsberg; Grzegorz Pietrasik; Ahmed F. Osman; Venkatesh Ravi; Jeanne M. Du‐Fay‐...; Zoe Post; Jeremiah Wasserlauf; Timothy R. Larsen; Kousik Krishnan; Richard Trohman; Henry D. Huang
• Keywords: Atrial tachycardia; Rf ablation

Abstract Background Persistent atrial fibrillation (AF) is associated with high recurrence rates of AF and atypical flutters or tachycardia (AFT) postablation. Laser balloon (LB) ablation the pulmonary vein (PV) ostia has similar efficacy as radiofrequency wide area circumferential (RF‐WACA); however, an approach LB (LB‐WACA) may further improve success rates. Objective To evaluate freedom from tachyarrhythmia (AFT/AF) postablation using RF‐WACA versus LB‐WACA in persistent patients. Methods This was a retrospective multicenter study. Patients were followed for up to 24 months via office visits, Holter, and/or device monitoring. The primary endpoint AFT/AF after single procedure. Secondary endpoints included AF, AFT, first‐pass isolation all PVs, procedural complications. Results Two hundred four patients studied (LB‐WACA: n = 103; RF‐WACA: 101). Patients’ baseline characteristics except group older (64 vs. 68, p .03). First‐pass achieved more often during LBA 88% 75%; .04). Procedure ( .36), LA dwell .41), fluoroscopy .44) time similar. mean follow‐up 506 ± 279 days. Sixty‐six had arrhythmic events including AFT 59 recurrences. higher arrhythmia‐free survival .009) procedures. In multivariate Cox regression model, compared (Adjusted HR 3.16 [95% CI: 1.13–8.83]; Conclusions arrhythmias mostly driven by lower occurrence RF‐WACA.