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(Circulation. 2009;120:1-2.)
© 2009 American Heart Association, Inc.

Clinical Summaries

Circulation: Clinical Summaries

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Visually-Guided Balloon Catheter Ablation of Atrial Fibrillation: Experimental Feasibility and First-in-Human Multicenter Clinical Outcome

 
Catheter-based electric isolation of the pulmonary veins can successfully treat patients with paroxysmal atrial fibrillation. Although conceptually straightforward, its clinical application has been hindered by important technical hurdles related to the complexity and patient-to-patient variability of pulmonary venous anatomy, as well as the difficulty in sequentially positioning the ablation catheter in a point-by-point contiguous fashion to isolate the veins. These considerations have led to the development of a balloon ablation catheter equipped with an endoscope that allows direct visualization of the atrial-venous junction and an easily maneuverable optical fiber that projects an arc of ablative laser energy (980 nm) onto the tissue in contact with the balloon face. This novel endoscopic ablation system was used in a series of preclinical porcine experiments and a first-in-human multicenter clinical study. The former demonstrated the feasibility to electrically isolate the pulmonary veins both immediately and persistently. In the clinical phase, a total of 30 patients with paroxysmal atrial fibrillation were treated. In the short term, >90% of the veins were successfully isolated with the balloon system. Long term, the 12-month drug-free freedom from atrial fibrillation after a single procedure was 60%. This study establishes the feasibility for this novel paradigm of catheter ablation of atrial fibrillation. Instead of relying on indirect cues to the location of the ablation catheter in relation to the pulmonary venous anatomy, endoscopic visualization permits the operator to directly visualize the tissue being targeted for ablation, an approach moving ever so closer to approximating the surgical experience. See p . . . [Full Text of this Article]

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