Laser balloon in pulmonary vein isolation for atrial fibrillation: current status and future prospects

ABSTRACT

Introduction

Visually guided laser balloon (LB) catheter has been an established modality dedicated for pulmonary vein (PV) isolation in patients with atrial fibrillation. The newly updated version of this novel device has technically evolved recent years.

Areas covered

This review will summarize the contemporary technical evolution of LB catheter. Available efficacy outcomes and the historical change of ablation style will be evaluated. Furthermore, the future perspectives for clinical practice are discussed.

Expert commentary

The initial LB ablation system provided comparable clinical results in PV isolation with other technologies, but with a unique strategical concept enabling the direct visualization of the tissue to cauterize. With multigenerational development, the LB catheter has been equipped with more compliant balloon for favorable PV occlusion and a robotically motor driven continuous ablation mode (RAPID mode). These technical innovations changed the concept of the ablation strategy using LB catheter as ‘point-by-point’ into ‘single-shot’ fashion. The remaining tasks are further improvements such as equipping with real-time recording system of intracardiac electrogram, durable structured balloon and the instrument for visualizing the cauterization area in a 360-degree panoramic view, which includes potential possibilities to develop this novel device to the more optimal device for PV isolation.

KEYWORDS:

• Arrhythmia
• atrial fibrillation
• endoscopic ablation system
• laser balloon
• catheter ablation

Article Highlights

• Pulmonary vein isolation using the laser balloon catheter has become established as a standard strategy.

• The ablation method has evolved from a ‘the point-by-point’ to a ‘single-shot’ fashion over multi-generational improvements.

• Further additional options such as acquiring a real-time diagnostic system, increased balloon durability, and/or 360-degree visualization feature are desired.

Disclosure statement

B Schmidt, S Bordignon, and J Chun received speaking honoraria from Cardiofocus Inc. The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.