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Electrical isolation of the superior vena cava by laser balloon ablation in patients with atrial fibrillation

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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.

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Acknowledgments

We acknowledge Kathleen Johanna Mc Ewen for the linguistic revision of the article.

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Authors and Affiliations

  1. Arrhythmias and Electrophysiology Robotic Unit, La Paz University Hospital, P. de la Castellana 261, 28046, Madrid, Spain

    Martín R. Arceluz, Pedro F. Cruz, Estela Falconi, Rosa Montes de Oca, Reina Delgado, Jorge Figueroa, Marta Ortega & José L. Merino

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  1. Martín R. Arceluz
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  2. Pedro F. Cruz
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  3. Estela Falconi
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  4. Rosa Montes de Oca
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  5. Reina Delgado
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  6. Jorge Figueroa
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  7. Marta Ortega
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  8. José L. Merino
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Contributions

Data Collection: Pedro F. Cruz, Estela Falconi, Rosa Montes de Oca, Reina, Delgado, Jorge Figueroa, Marta Ortega.

Critical revision of Article: José L. Merino.

Corresponding authors

Correspondence to Martín R. Arceluz or José L. Merino.

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The authors declare that they have no conflict of interest.

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Arceluz, M.R., Cruz, P.F., Falconi, E. et al. Electrical isolation of the superior vena cava by laser balloon ablation in patients with atrial fibrillation. J Interv Card Electrophysiol 53, 217–223 (2018). https://doi.org/10.1007/s10840-018-0380-9

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  • DOI: https://doi.org/10.1007/s10840-018-0380-9

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