New treatment for AF - one hour laser surgery

" It is also quicker, taking an hour or less. Other ablations can take hours. This means that patients do not need as much anaesthetic and can recover more quickly. "

...

"Research carried out at centres worldwide suggests this treatment is effective and safe. A study of 71 AF patients treated with the laser, published in the Spanish Journal of Cardiology in 2016, showed 99 per cent of pulmonary veins were successfully treated.

I have now treated 500 patients with laser ablation and trained doctors here and abroad in its use. It can be a game-changer."

[www.dailymail.co.uk]

This is game changer...if my 2018 ablation fails at some point down the road i will be looking at this possibly.
What 10-15% of afib or something like that triggers occurs outside the PV's how would that be addressed....my ablation was strictly PV and it worked beautifully but what about non PVers?

From the article: It is unique in that it lets the cardiologist see the veins using a camera inserted exactly where the laser is. We don’t have to rely on X-rays or computer- simulated images, so we can ablate the tissue more accurately. The balloon we use in this ablation is also very flexible and adjustable, so it can adapt to fit all veins.

The laser energy is also thought to damage the tissue more effectively than electrodes, creating durable scars that last. This all gives us the best chance of a successful first-time procedure.

It is also quicker, taking an hour or less. Other ablations can take hours. This means that patients do not need as much anaesthetic and can recover more quickly.

Laser ablation can be done with either a local or a general anaesthetic. Two 2mm incisions are made in the groin and a thin plastic tube is threaded through the femoral vein at the top of the thigh using ultrasound.

A wire is threaded through to the heart and a plastic sheath is passed into the left atrium.

The laser and camera are inside a deflated balloon, which is passed through the sheath and inflated inside each of the pulmonary veins using special water, one by one.

Seems like it's the same as the cryoballoon pvi, but with a camera. More complex ablations looking for problem areas throughout the atrium, don't seem to be part of this new treatment. It wouldn't have done me any good since the pulmonary veins were only a part of my two ablations.

Hi Scribbler, vanlith and Ken,

The Heart Light Laser X3 system is an evolution of its earlier iterations and has the advantage of a more compliant and flexible balloon as part of its balloon-type catheter design. It is a bit faster for doing a standard PVI, but is it not really meant for more advanced cases .. as Ken insightfully surmised above.

The camera and laser system are nice additions and give's a millimeter or so greater accuracy compared to a cryoballoon catheter with its stiffer balloon compliance, but other than these modest enhancements it still is limited primarily to PVI's alone.

This system will be appealing mainly for less-to-moderately experienced operators who focus mostly on more basic PVI ablations. The thing is, while it may offer some advantages relative to Cryo ablations for basic early to middle-stage paroxysmal AFIB cases ... I would definitely choose an elite level operator with advanced RF skills first off, for any Afibber suffering from even moderate to advanced paroxysmal AFIB and without question for those with more advance AFIB like persistent and Long-standing persistent AFIB.

I would call this Heart light laser system an incremental upgrade over Cryo, but not at all necessarily a game changer by any means, especially with it not really being able to address non-PVI triggers effectively,

In all the many ablation reports I have read over the last 12 years or so, it is not uncommon to see a few non-PV triggers even in fairly early paroxysmal cases ... and in more active cases it is almost ubiquitous to see a consistent number of non-PV triggers found, not to mention in almost every single persistent and LSPAF cases they will have several clusters of non-PV triggers in both the left and right atria well away from any pulmonary vein ostiums that must be quelled for long term durable freedom from all atrial arrhythmia.

Also, just in the next couple of years widespread availability of PFA (Pulse Field Ablation) .. also called Electroporation ... will almost certainly become ubiquitous and that technology will represent a true major breakthrough far beyond any incremental advances in balloon technology.

A good rule of thumb in this field is to always seek out the most experienced possible ablation maestro one can possibly find and then let them choose the correct technology for your procedure. It's always wise, in my view, for us laypersons not to get too enthralled with the tech side of this business, such that we might make that our focus and perhaps wind up choosing the exciting-sounding new tech first.

There are large basement storerooms in the bowels of many large EP centers that are full of dust-covered old technology that was surely going to be the next holy grail, but that never quite panned out.

The very best ablation EPs in the world are your best resource for helping you make the best choices for your particular ablation.

Cheers!
Shannon

Shannon
Could you enlighten on the prospect of this new procedure which is supposedly less harmful then radiofrequency ablation.
thk you

That's what he did in the post right above yours.

thank you,