Electrical Isolation of the Superior Vena Cava by Laser Balloon Ablation in Patients with Atrial Fibrillation

Overview

Journal J Interv Card Electrophysiol

Publisher Springer

Date 2018 May 8

PMID 29732527

Citations 1

Authors

Martin R Arceluz

Pedro F Cruz

Estela Falconi

Rosa Montes de Oca

Reina Delgado

Jorge Figueroa

Marta Ortega

Jose L Merino

Affiliations

Soon will be listed here.

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.

Citing Articles

Efficacy, Safety and Feasibility of Superior Vena Cava Isolation in Patients Undergoing Atrial Fibrillation Catheter Ablation: An Up-to-Date Review.

Vrachatis D, Papathanasiou K, Kossyvakis C, Giotaki S, Deftereos G, Kousta M Biomedicines. 2023; 11(4).

PMID: 37189639 PMC: 10136264. DOI: 10.3390/biomedicines11041022.

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