Efficacy and safety of visually guided laser balloon versus cryoballoon ablation for paroxysmal atrial fibrillation: a systematic review and meta-analysis

Ye, Wenyi; Chen, Qian; Fan, Guangci; Zhou, Xinbin; Wang, Xiao; Mao, Wei; Li, JuanJuan

doi:10.3389/fcvm.2023.1229223

Cited by 4 publications

(1 citation statement)

References 34 publications

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“…In addition to RF and cryoenergy, lasers represent another energy source feasible for AF ablation. Three generations of laser balloon ablation systems have been developed (namely HeartLight, HeartLight Excalibur, and HeartLight X3 by CardioFocus, Marlborough, MA, USA) and several studies have demonstrated the non-inferiority of lasers compared to RF or cryoablation systems in terms of safety and efficacy, with a success rate ranging from 61.7% to 82.3% [25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Pulsed Field Energy in Atrial Fibrillation Ablation: From Physical Principles to Clinical Applications

Pierucci,

Mariani,

Laviola

et al. 2024

JCM

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Atrial fibrillation, representing the most prevalent sustained cardiac arrhythmia, significantly impacts stroke risk and cardiovascular mortality. Historically managed with antiarrhythmic drugs with limited efficacy, and more recently, catheter ablation, the interventional approach field is still evolving with technological advances. This review highlights pulsed field ablation (PFA), a revolutionary technique gaining prominence in interventional electrophysiology because of its efficacy and safety. PFA employs non-thermal electric fields to create irreversible electroporation, disrupting cell membranes selectively within myocardial tissue, thus preventing the non-selective damage associated with traditional thermal ablation methods like radiofrequency or cryoablation. Clinical studies have consistently shown PFA’s ability to achieve pulmonary vein isolation—a cornerstone of AF treatment—rapidly and with minimal complications. Notably, PFA reduces procedure times and has shown a lower incidence of esophageal and phrenic nerve damage, two common concerns with thermal techniques. Emerging from oncological applications, the principles of electroporation provide a unique tissue-selective ablation method that minimizes collateral damage. This review synthesizes findings from foundational animal studies through to recent clinical trials, such as the MANIFEST-PF and ADVENT trials, demonstrating PFA’s effectiveness and safety. Future perspectives point towards expanding indications and refinement of techniques that promise to improve AF management outcomes further. PFA represents a paradigm shift in AF ablation, offering a safer, faster, and equally effective alternative to conventional methods. This synthesis of its development and clinical application outlines its potential to become the new standard in AF treatment protocols.

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Section: Introductionmentioning

confidence: 99%