Long-term follow-up of patients treated with laser balloon for atrial fibrillation: A high volume center experience with the first- and second-generation laser balloon.

ABSTRACT

Background: Laser balloon (LB) pulmonary vein isolation (PVI) is an established ablation technique for atrial fibrillation (AF). We report long-term follow-up and procedural data of LB-PVI and we compare the first and second LB generation. Methods: Patients undergoing LB ablation with first- (LB1) or second-generation LB (LB2) for AF were retrospectively enrolled and divided into two groups. Procedural endpoint was complete PVI. Clinical success was defined as no recurrence of AF/atrial tachycardia after a 90 days blanking period. Results: 538 patients were included (age 66 ± 10 years, 58% paroxysmal AF), 427 in LB1 and 111 in LB2. 2079 PVs were targeted and 2073 (99.7%) were successfully isolated; 2027 (97.5%) using solely the LB. Additional touch-up ablation was limited (46 PVs; 2.2%) with no difference between the groups. Procedural (LB1 120 ± 33 minutes vs. LB2 99 ± 22 min; p < .001) and fluoroscopy time (LB1 11.2 ± 5 min vs. LB2 8.5 ± 3 min; p < .001) were shorter with LB2. The complication rate was 8.9% (LB1 10.1% vs. LB2 4.5%; p = .067) with most complications resulting from the access site (21/48). Overall freedom from AF after 1-year was 73.7% (paroxysmal AF 76.9%; persistent AF 69.3%; p < .001) with no difference between the groups (LB1 73.4% vs. LB2 74.7%; p = .491). Conclusion: LB showed a high efficacy and acceptable safety, with numerically lower complication rates with the second-generation LB. Procedure and fluoroscopy times were shorter with LB2. Overall, 73.7% of patients were free from AF at 1-year, with comparable results among both generations.