Conclusion:
The VGLA guided PVI was a useful therapeutic tool even in patients with
an LCPV. The presence of an LCPV was not associated with any atrial
tachyarrhythmia recurrence.
Keywords
Left common pulmonary vein, catheter ablation, pulmonary vein isolation,
laser balloon, atrial fibrillation
Introduction
Pulmonary vein isolation (PVI) is an effective treatment of atrial
fibrillation (AF). A balloon-based visually guided laser ablation (VGLA)
is considered to be a useful therapeutic tool for achieving a
PVI1). A prior multicenter study revealed that VGLA was
non-inferior to radiofrequency ablation in terms of the efficacy and
safety in curing paroxysmal and persistent AF2,3).
Moreover, a recent prospective randomized study showed that VGLA was as
effective and safe as a cryoballoon (CB) guided PVI4).
The shape of the pulmonary veins (PVs) and left atrium varies among the
candidates for AF ablation, and a
left common pulmonary vein (LCPV) is the most frequently observed
anatomical abnormality that operators encounter in performing PVI.
Although radiofrequency energy (RF) ablation can be applied in a
point-by-point fashion at the LCPV ostium without any difficulty, the
balloon may not be able to occlude the PVs, which is mandatory for a
successful PVI. The results of a balloon-based PVI may not be
satisfactory especially in patients with a relatively large LCPV, and we
previously reported that a CB guided PVI was unsuccessful in 15% of
patients with an LCPV5). However, the clinical safety
and efficacy of a VGLA has never been fully investigated in patients
with an LCPV. We investigated the procedural safety and efficacy of VGLA
in the patients with an LCPV.