Long-term outcome and PVI durability
The present study demonstrated that the predictors of any atrial
tachyarrhythmia recurrence were not associated with the presence of an
LCPV, but were related to the recurrence during the blanking period. In
general, recurrence within 90 days of the blanking period is a major
risk factor for any atrial tachyarrhythmia recurrence after the blanking
period17-19), which was similar to the results of the
VGLA in the present study.
VGLA enabled maintaining a high durable PVI. Nagase et al. and Okishige
et al. demonstrated that the lesion depth, lesion volume, and maximum
lesion diameter were associated with the laser output energy and total
laser energy delivered in an in vitro model20,21). A
prior multicenter study revealed that 86% of the PVs remained isolated,
and 62% of the patients had all their PVs remaining isolated after the
VGLA guided PVI22). In the present study, PV
reconnections were found in 24 out of 57 (42.1%) PVs among the patients
who had recurrent atrial tachyarrhythmias and underwent a redo
procedure. However, no electrical reconnections were found in any of the
LCPV cases. The VGLA might create a highly durable lesion for LCPVs as
derived from the present study results.