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Laser-Based Approach to Cardiac Mapping and Arrhythmia Ablation

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Lasers in Cardiovascular Interventions

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Abstract

Cardiovascular laser application is a new procedure in the diagnosis and treatment of diseases based on a key technology the Laser. In the past three decades we have performed numerous in-vitro tests and in-vivo studies by using the laser method. Aim was to validate limitations and practicability of this new technique for a useful application in the heart chambers and vessels.

Experimental tests with various laser power sources, mainly the 1064 nm Nd:YAG laser in the continuous wave (cw) mode of radiation, and various energy transmission systems, mainly with an open irrigated electrode-laser mapping and ablation (ELMA) catheter, were performed on bovine myocardium, in the beating heart of rabbits, porks, and in a total of 153 anesthetized dogs, mainly beagles. Tests were performed with the aim to elucidate during laser catheter applications the optimal energy settings, catheter irrigation flow, the influence of catheter orientation and pressure on the targeted endocardial or epicardial surfaces, and the controllability of laser lesion formation. Subsequently, a first clinical multicenter study trial of arrhythmia ablation in patients with a follow-up of 5–8 years was added by using the ELMA catheter.

As compared to other methods, including radiofrequency and cryoablation, the laser produces larger lesions, faster, and in a more controllable manner. The laser is safer and more effective with a lower burden to patients. The laser method has the potential for becoming an all pervasive procedure for cardiovascular diseases including arrhythmia ablation, the Chagas disease, the hypertrophic obstructive cardiomyopathy (HOCM)-ablation, renal denervation, and side selective transseptal puncture procedure. We conclude that this is the first large prospective validation that the laser can supersede all the devices with limitations in cardiovascular applications at present in use.

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Authors and Affiliations

  1. Department of Research, Development and Education, CCEP Center Taufkirchen, Taufkirchen, D-82024, Germany

    Helmut P. Weber MD

  2. Department of Anesthesiology, Hospital Neuperlach, Teaching Hospital of the LM-University of Munich, Munich, Germany

    Michaela Sagerer-Gerhardt MD

Authors
  1. Helmut P. Weber MD
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  2. Michaela Sagerer-Gerhardt MD
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Correspondence to Helmut P. Weber MD .

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Editors and Affiliations

  1. Division of Cardiology, Charles George VA Medical Center, Asheville, North Carolina, USA

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Weber, H.P., Sagerer-Gerhardt, M. (2015). Laser-Based Approach to Cardiac Mapping and Arrhythmia Ablation. In: Topaz, O. (eds) Lasers in Cardiovascular Interventions. Springer, London. https://doi.org/10.1007/978-1-4471-5220-0_17

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  • DOI: https://doi.org/10.1007/978-1-4471-5220-0_17

  • Publisher Name: Springer, London

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