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Energy titration strategies with the endoscopic ablation System: lessons from the high-dose vs. low-dose laser ablation study

Standard

Energy titration strategies with the endoscopic ablation System: lessons from the high-dose vs. low-dose laser ablation study. / Bordignon, Stefano; Chun, Kyoung-Ryul Julian; Gunawardene, Melanie; Urban, Verena; Kulikoglu, Mehmet; Miehm, Kristin; Brzank, Beate; Schulte-Hahn, Britta; Nowak, Bernd; Schmidt, Boris.

in: EUROPACE, Jahrgang 15, Nr. 5, 01.05.2013, S. 685-689.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Bordignon, S, Chun, K-RJ, Gunawardene, M, Urban, V, Kulikoglu, M, Miehm, K, Brzank, B, Schulte-Hahn, B, Nowak, B & Schmidt, B 2013, 'Energy titration strategies with the endoscopic ablation System: lessons from the high-dose vs. low-dose laser ablation study', EUROPACE, Jg. 15, Nr. 5, S. 685-689. https://doi.org/10.1093/europace/eus352

APA

Bordignon, S., Chun, K-R. J., Gunawardene, M., Urban, V., Kulikoglu, M., Miehm, K., Brzank, B., Schulte-Hahn, B., Nowak, B., & Schmidt, B. (2013). Energy titration strategies with the endoscopic ablation System: lessons from the high-dose vs. low-dose laser ablation study. EUROPACE, 15(5), 685-689. https://doi.org/10.1093/europace/eus352

Vancouver

Bordignon S, Chun K-RJ, Gunawardene M, Urban V, Kulikoglu M, Miehm K et al. Energy titration strategies with the endoscopic ablation System: lessons from the high-dose vs. low-dose laser ablation study. EUROPACE. 2013 Mai 1;15(5):685-689. https://doi.org/10.1093/europace/eus352

Bibtex

@article{18a412735f684b669343a7cb61c93a8d,
title = "Energy titration strategies with the endoscopic ablation System: lessons from the high-dose vs. low-dose laser ablation study",
abstract = "AIMS: To assess the effects of low-dose (LD) and high-dose (HD) ablation on acute and chronic success in patients with atrial fibrillation (AF). While the concept of visually guided pulmonary vein isolation (PVI) has been established little is known on energy titration using laser ablation.METHODS AND RESULTS: In 60 patients with AF, PVI using the endoscopic ablation system (EAS) was performed in two groups. Visually guided ablation was carried out after obtaining optimal tissue contact with 5.5-8.5 W in the LD group and with >8.5 W in the HD group. Acute PVI after a single visually guided circular lesion set was achieved in 89% (HD) and 69% (LD), respectively, (P = 0.0004). In 70 and 39% of patients all PVs were isolated after a single ablation circle in the HD and LD group, respectively, (P = 0.009). After gap ablation all PVs were isolated with the EAS. More energy was deployed (6483 ± 1834 vs. 5306 ± 2258 Ws; P ≤ 0.0001) with less applications (31.6 ± 8 vs. 35.2 ± 15 applications per PV; P = 0.03) leading to shorter procedure times (128 ± 17 vs. 154 ± 38 min; P = 0.001). During median follow-up of 311 days (261-346) recurrence rate was 17 and 40% in the HD and LD group, respectively. In both groups one phrenic nerve palsy was observed.CONCLUSION: For the first time, it was demonstrated that high ablation power affects acute and chronic outcomes. High-dose laser balloon ablation allows for an acute PVI rate of 89% solely by visually guided circular ablation and is associated with a chronic success rate of 83% after a single procedure.",
keywords = "Atrial Fibrillation, Cardiac Catheterization, Dose-Response Relationship, Radiation, Endoscopy, Energy Transfer, Female, Humans, Laser Therapy, Male, Middle Aged, Radiation Dosage, Treatment Outcome",
author = "Stefano Bordignon and Chun, {Kyoung-Ryul Julian} and Melanie Gunawardene and Verena Urban and Mehmet Kulikoglu and Kristin Miehm and Beate Brzank and Britta Schulte-Hahn and Bernd Nowak and Boris Schmidt",
year = "2013",
month = may,
day = "1",
doi = "10.1093/europace/eus352",
language = "English",
volume = "15",
pages = "685--689",
journal = "EUROPACE",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "5",

}

RIS

TY - JOUR

T1 - Energy titration strategies with the endoscopic ablation System: lessons from the high-dose vs. low-dose laser ablation study

AU - Bordignon, Stefano

AU - Chun, Kyoung-Ryul Julian

AU - Gunawardene, Melanie

AU - Urban, Verena

AU - Kulikoglu, Mehmet

AU - Miehm, Kristin

AU - Brzank, Beate

AU - Schulte-Hahn, Britta

AU - Nowak, Bernd

AU - Schmidt, Boris

PY - 2013/5/1

Y1 - 2013/5/1

N2 - AIMS: To assess the effects of low-dose (LD) and high-dose (HD) ablation on acute and chronic success in patients with atrial fibrillation (AF). While the concept of visually guided pulmonary vein isolation (PVI) has been established little is known on energy titration using laser ablation.METHODS AND RESULTS: In 60 patients with AF, PVI using the endoscopic ablation system (EAS) was performed in two groups. Visually guided ablation was carried out after obtaining optimal tissue contact with 5.5-8.5 W in the LD group and with >8.5 W in the HD group. Acute PVI after a single visually guided circular lesion set was achieved in 89% (HD) and 69% (LD), respectively, (P = 0.0004). In 70 and 39% of patients all PVs were isolated after a single ablation circle in the HD and LD group, respectively, (P = 0.009). After gap ablation all PVs were isolated with the EAS. More energy was deployed (6483 ± 1834 vs. 5306 ± 2258 Ws; P ≤ 0.0001) with less applications (31.6 ± 8 vs. 35.2 ± 15 applications per PV; P = 0.03) leading to shorter procedure times (128 ± 17 vs. 154 ± 38 min; P = 0.001). During median follow-up of 311 days (261-346) recurrence rate was 17 and 40% in the HD and LD group, respectively. In both groups one phrenic nerve palsy was observed.CONCLUSION: For the first time, it was demonstrated that high ablation power affects acute and chronic outcomes. High-dose laser balloon ablation allows for an acute PVI rate of 89% solely by visually guided circular ablation and is associated with a chronic success rate of 83% after a single procedure.

AB - AIMS: To assess the effects of low-dose (LD) and high-dose (HD) ablation on acute and chronic success in patients with atrial fibrillation (AF). While the concept of visually guided pulmonary vein isolation (PVI) has been established little is known on energy titration using laser ablation.METHODS AND RESULTS: In 60 patients with AF, PVI using the endoscopic ablation system (EAS) was performed in two groups. Visually guided ablation was carried out after obtaining optimal tissue contact with 5.5-8.5 W in the LD group and with >8.5 W in the HD group. Acute PVI after a single visually guided circular lesion set was achieved in 89% (HD) and 69% (LD), respectively, (P = 0.0004). In 70 and 39% of patients all PVs were isolated after a single ablation circle in the HD and LD group, respectively, (P = 0.009). After gap ablation all PVs were isolated with the EAS. More energy was deployed (6483 ± 1834 vs. 5306 ± 2258 Ws; P ≤ 0.0001) with less applications (31.6 ± 8 vs. 35.2 ± 15 applications per PV; P = 0.03) leading to shorter procedure times (128 ± 17 vs. 154 ± 38 min; P = 0.001). During median follow-up of 311 days (261-346) recurrence rate was 17 and 40% in the HD and LD group, respectively. In both groups one phrenic nerve palsy was observed.CONCLUSION: For the first time, it was demonstrated that high ablation power affects acute and chronic outcomes. High-dose laser balloon ablation allows for an acute PVI rate of 89% solely by visually guided circular ablation and is associated with a chronic success rate of 83% after a single procedure.

KW - Atrial Fibrillation

KW - Cardiac Catheterization

KW - Dose-Response Relationship, Radiation

KW - Endoscopy

KW - Energy Transfer

KW - Female

KW - Humans

KW - Laser Therapy

KW - Male

KW - Middle Aged

KW - Radiation Dosage

KW - Treatment Outcome

U2 - 10.1093/europace/eus352

DO - 10.1093/europace/eus352

M3 - SCORING: Journal article

C2 - 23129544

VL - 15

SP - 685

EP - 689

JO - EUROPACE

JF - EUROPACE

SN - 1099-5129

IS - 5

ER -