Laser catheter ablation of long- lasting persistent atrial fibrillation: Longterm results

Weber, H; Sagerer-Gerhardt, Michaela; Heinze, Armin

doi:10.4022/jafib.1588

Cited by 6 publications

(4 citation statements)

References 46 publications

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“…In order to demonstrate ablation monitoring, liver and heart tissue were chosen due to their clinical relevance [4][5][6][7] , as well as their well characterised optical and thermal properties 50,51 . It was found that for the same laser power, liver tissue was more easily ablated than heart tissue, forming larger lesions in the same ablation period (Figs.…”

Section: Discussionmentioning

confidence: 99%

“…With these treatments, the target tissue is heated or frozen using a variety of techniques to destroy abnormal tissue. This ablation can be carried out in a variety of ways 2 , including electromagnetic thermal techniques, which have been widely used for minimally invasive surgeries 3,4 , and laser ablation, which has proven to be effective in clinical scenarios such as atrial fibrillation ablation 5 and several types of tumour resection 4,6,7 . Atrial fibrillation (AF) is an application of particular interest as it affects > 12% of the population aged 65 and above 8 .…”

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confidence: 99%

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Dual-modality fibre optic probe for simultaneous ablation and ultrasound imaging

Zhang

Beard

et al. 2022

Commun Eng

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All-optical ultrasound (OpUS) is an emerging high resolution imaging paradigm utilising optical fibres. This allows both therapeutic and imaging modalities to be integrated into devices with dimensions small enough for minimally invasive surgical applications. Here we report a dual-modality fibre optic probe that synchronously performs laser ablation and real-time all-optical ultrasound imaging for ablation monitoring. The device comprises three optical fibres: one each for transmission and reception of ultrasound, and one for the delivery of laser light for ablation. The total device diameter is < 1 mm. Ablation monitoring was carried out on porcine liver and heart tissue ex vivo with ablation depth tracked using all-optical M-mode ultrasound imaging and lesion boundary identification using a segmentation algorithm. Ablation depths up to 2.1 mm were visualised with a good correspondence between the ultrasound depth measurements and visual inspection of the lesions using stereomicroscopy. This work demonstrates the potential for OpUS probes to guide minimally invasive ablation procedures in real time.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Dual-modality fibre optic probe for simultaneous ablation and ultrasound imaging

Zhang

Beard

et al. 2022

Commun Eng

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“…Postupně byla zapojena celá řada metod zvyšujících účinnost a bezpečnost RFA (16)(17)(18)(19)(20)(21). KA byla následně doplněna dalšími technologiemi jako například kryoablace (22) či laserové ablace (23), které jsou obdobně jako RFA založené na termálním faktoru v tvorbě ablačních lézí. Recentně se do klinické praxe dostávají netermální ablační metody založené na efektu elektroporace (24)(25)(26)(27).…”

Section: úVodunclassified

Mid-term success rate of single stage hybrid ablation of persistent and long-term persistent atrial fibrillation

Pešl¹,

Kulik²,

Ostřížek³

et al. 2022

Vnitř Lék

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Úvod: Thorakoskopická radiofrekvenční ablace technikou "single stage" je metodou léčby perzistující a dlouhodobě perzistující fibrilace síní (FS) nabízející možnost pro pacienty jinak neřešitelné konvenční katétrovou radiofrekvenční ablací. Prezentujeme úvodní soubor pacientů po zavedení nové metody na našem pracovišti. Metody: Celkem 52 pacientů ve věku 61,82 ± 9,7 roku podstoupilo v období září 2016 -březen 2019 single stage hybridní ablaci (thorakoskopická izolace plicních žil a "box lesion" následovaná katétrovým ověřením efektu chirurgické části výkonu) pro symptomatickou perzistující a dlouhodobě perzistující FS s výrazně dilatovanou levou síní 57,9 ± 11,0 mm. Výsledky: Střední doba výkonu dosahovala 232 minut a střední doba hospitalizace byla 10 dnů. Při propuštění mělo 52 pacientů (100 %) sinusový rytmus. Šestiměsíční kontrolu absolvovalo 48 z 52 pacientů (92,3 %). Při první kontrole po třech měsících od výkonu bylo 41 ze 48 (85,4 %) pacientů bez záchytu FS, při druhé kontrole po 6 měsících bylo bez FS 38 ze 44 dále sledovaných pacientů (86,4). Akutní komplikace byla zaznamenána 1× perforace levé síně řešená úspěšně suturou a 1× tranzitorní ischemická ataka bez trvalých následků. Pozdní komplikace 1× masivní plicní embolizace, 1× atrioezofageální píštěl. Nebyl zaznamenán žádný periprocedurální infarkt myokardu ani cévní mozková příhoda s trvalými následky. Závěr: Hybridní thorakoskopická a katétrová ablace v jednom sezení je účinná a relativně bezpečná miniinvazivní metoda léčby dlouhodobě perzistující fibrilace síní.

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“…However, LITT, which delivers light via optical fibres with small lateral dimensions and high mechanical flexibility, is preferred for treating deep targets in the body [ 4 ]. In addition, the minimal invasiveness of LITT makes it more suitable for patients at high risk of complications due to pre-existing comorbidities [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Miniaturised dual-modality all-optical ultrasound probe for laser interstitial thermal therapy (LITT) monitoring

Zhang¹,

Bodian

Zhang³

et al. 2023

Biomed. Opt. Express

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All-optical ultrasound (OpUS) has emerged as an imaging paradigm well-suited to minimally invasive imaging due to its ability to provide high resolution imaging from miniaturised fibre optic devices. Here, we report a fibre optic device capable of concurrent laser interstitial thermal therapy (LITT) and real-time in situ all-optical ultrasound imaging for lesion monitoring. The device comprised three optical fibres: one each for ultrasound transmission, reception and thermal therapy light delivery. This device had a total lateral dimension of <1 mm and was integrated into a medical needle. Simultaneous LITT and monitoring were performed on ex vivo lamb kidney with lesion depth tracked using M-mode OpUS imaging. Using one set of laser energy parameters for LITT (5 W, 60 s), the lesion depth varied from 3.3 mm to 8.3 mm. In all cases, the full lesion depth could be visualised and measured with the OpUS images and there was a good statistical agreement with stereomicroscope images acquired after ablation (t=1.36, p=0.18). This work demonstrates the feasibility and potential of OpUS to guide LITT in tumour resection.

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Laser catheter ablation of long- lasting persistent atrial fibrillation: Longterm results

Cited by 6 publications

References 46 publications

Dual-modality fibre optic probe for simultaneous ablation and ultrasound imaging

Dual-modality fibre optic probe for simultaneous ablation and ultrasound imaging

Mid-term success rate of single stage hybrid ablation of persistent and long-term persistent atrial fibrillation

Miniaturised dual-modality all-optical ultrasound probe for laser interstitial thermal therapy (LITT) monitoring

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