Application Of Ablation Research Articles

Application of Microwave Ablation in Laparoscopic Partial Splenectomy

Application of Microwave Ablation in Laparoscopic Partial Splenectomy

Application of irreversible electroporation ablation in oncology - a narrative review

Irreversible electroporation-IRE is an innovative cancer treatment method that can selectively destroy cancer cells without damaging surrounding tissues. It is a safe and effective alternative to traditional methods, with the patient faster recover potential and spare critical body structures such as blood vessels and nerves.In surgical oncology, the IRE treatment technique is used especially in cases where other methods are not possible or have limited effectiveness. The method is proving to be seen as an effective local treatment with good clinical results and limited side effects in prostate, biliary, pancreatic, kidney and liver cancers.

High-pulse-energy ultrafast 3 µm laser generation through OPG/DFG in PPMgLN

Abstract We report high-pulse-energy ultrafast 3 µm laser generation through optical parametric generation/difference frequency generation (OPG/DFG) in periodically poled magnesium-oxide-doped lithium niobate (PPMgLN). A commercial 1030 nm femtosecond laser is applied as the pump light and a homemade broadband nanosecond pulse laser around 1580 nm is used as the signal light in DFG. The broadband 1580 nm laser has a master oscillator power amplifier (MOPA) structure with a directly modulated superluminescent light-emitting diode (SLED) as the pulse seed and three stages of Er/Yb fiber amplifiers to lift its average power. A portion of the 1030 nm output pulse is converted to an electronic pulse via a pin detector, which is used as the trigger signal of the SLED driving circuit to ensure synchronization between the signal and the 1030 nm pump pulse. When injecting 2.12 W pump light into the PPMgLN, a broadband mid-infrared (MIR) output of 280 mW can be achieved directly through OPG with a center wavelength around 2.94 μm, a pulse width of 1.38 ps and a pulse repetition frequency of 500 kHz. The corresponding MIR pulse energy is 0.56 µJ. When injecting 2.62 W signal light simultaneously, a MIR output of 300 mW is achieved through the DFG process at the same pulse repetition frequency, corresponding to a pulse energy of 0.6 µJ. The conversion efficiency of the ultrafast pump laser to MIR reaches 14.1%. This high-pulse-energy 3 μm ultrafast laser has great prospects for applications in biological tissue ablation.

High efficiency femtosecond laser ablation of alumina ceramics under the filament induced plasma shock wave

Femtosecond laser filament enables energy transfer over long distances, which is of great value for studying long-range ablation. However, the energy coupling of filament with the plasma generated by the ablation process leads to a very complex behavior which limits the ablation efficiency. This study systematically investigated the ablation mechanism of laser-induced filament in alumina ceramic. The plasma shock wave was initially investigated using spectral detection techniques combined with Sedov-Taylor theory. The results indicated that the maximum plasma shock wave reached 30 MPa under the irradiated by a 1 mJ fs laser. The theoretical analysis confirmed the effectiveness of the filament-induced plasma shock wave in enhancing the ablation rate of alumina ceramic. In this context, the experimental studies were conducted with varying filament positions and pulse energies, and the corresponding ablation rates for each parameter were investigated. The filament in the ablation process was found to has a secondary sputtering effect, which is an effective contributor to enhance the ablation rate. The corresponding ablation depth reach to 550 μm while achieving an ablation rate of 3.1 μm3/μJ. Finally, the coupling mechanism between the femtosecond laser filament and the plasma shock wave was systematically revealed. This research will facilitate future laser remote ablation applications with high efficiency.

Amorphous Silicon Diodes as Temperature Sensors in Microwave Thermal Ablation Applications: An Initial Assessment

Amorphous Silicon Diodes as Temperature Sensors in Microwave Thermal Ablation Applications: An Initial Assessment

Incomplete ablation of thyroid cancer: Achilles’ Heel?

BackgroundIn recent years, the incidence of thyroid nodules has increased significantly. There are various ways to treat thyroid nodules, and ablation therapy is one of the important ways to treat thyroid nodules. However, there are many complications and deficiencies in the current ablation treatment of thyroid nodules, especially the incomplete ablation of thyroid cancer nodules, which limits the further application of ablation technology.Case SummaryIn this paper, we report two cases of incomplete ablation of thyroid nodules, one of which underwent surgical treatment due to anxiety after ablation, and the postoperative pathology confirmed that there was still residual papillary thyroid carcinoma, and the other patient underwent an operation after ablation, but visited our medical institution again due to cervical lymph node metastasis in a short period of time, and after radical cervical lymph node dissection, pathology confirmed multiple cervical lymph node metastasis. Radionuclide therapy was performed after surgery, and two patients are currently receiving endocrine suppression therapy, and their condition is stable with no signs of recurrence.ConclusionThe incomplete ablation of thyroid cancer nodules limits the development of ablation therapy, making ablation treatment a double-edged sword. Guidelines and expert consensus can guide their development, but they need to evolve with the times, and a multidisciplinary diagnostic team can help screen the most suitable patients. Only by using this technology more standardly, using the most appropriate technology, and treating the most suitable patients, can benefit more and more patients.

Theranostic nano-enabled polyurethane eso-sponges coupled to surface enhanced Raman scattering for detection and control of bacteria killing

Herein, a facile approach toward converting a three-dimensional polyurethane sponge (PUS), employed in endoluminal vacuum-assisted closure (endo-VAC) therapies, in a theranostic material able to detect and to inhibit bacteria growth, has been reported. The endo-VAC PUS presented sensitivity to Gram-positive and Gram-negative bacterial species thanks to its functionalization with gold and silver antibacterial nanoparticles (NPs). PUS with chitosan-stabilized Au-NPs achieved 5.26 ± 0.17 logs and 2.78 ± 0.34 logs of reduction of bacteria growth, whereas the sponges functionalized with phenolated lignin Ag-NPs offered slightly inferior values (4.77 ± 0.36 logs and 2.03 ± 0.37 logs, respectively), against Escherichia coli and Staphylococcus aureus pathogens, respectively, after the application of photothermal ablation. The in vitro antimicrobial studies were contrasted with the in-situ monitoring of bacteria localization and inactivation with excitation lasers of 532 and 785 nm wavelengths, respectively, in the Raman equipment. The novel theranostic nano-enabled antimicrobial PU sponges offer unprecedented possibilities for the improvement of the endo-VAC treatments and extrapolation of the methodology to other plastic-based implants to combat antimicrobial resistances.

All-fiber passively Q-switched Tm-doped laser with a mode field area mismatched Tm-doped saturable absorber.

We demonstrate a high peak power, all-fiber passively Q-switched Tm-doped laser operating at 1940 nm for applications in soft tissue ablation. High peak power and passive Q-switching were achieved via a clad pumped gain fiber and a smaller core Tm-doped fiber saturable absorber respectively. Clad pumping was achieved via two 30 W diodes operating at 793 nm. At 50.7 W of pump power, laser pulses with 140 ns FWHM duration and average power of 14.5 W were obtained at a repetition rate of 328 kHz which corresponded to a pulse energy of ~44 µJ and a peak power of ~316 W. The laser had a narrow 0.14 nm linewidth at the maximum output power. The laser was used to cut chicken breast as well as ovine cortical and subcortical brain tissues and average ablation efficiencies of 29, 40 and 42% were obtained, respectively. Cutting speeds of 10 mm/s for ovine brain tissue and 5 mm/s for chicken breast were achieved. Further resection experiments were performed with the target tissue placed under a thin layer of water. A resected volume with length, width and depth of 5 mm, 2.5 mm, and 2.8 mm were obtained, corresponding to a resection rate of ~0.58 mm3/s. To our best knowledge, this is the first report of an all-fiber clad-pumped passively Q-switched Tm-doped fiber laser with a core mismatched saturable absorber being used for tissue ablation experiments.

Stereo electroencephalography-guided radiofrequency ablation in focal epilepsia partialis continua: illustrative case.

Epilepsia partialis continua (EPC) is a variant of focal motor status epilepticus that can occur as a single or repetitive episode with progressive or nonprogressive characteristics. The authors describe the feasibility of identifying focal EPC in a 33-year-old woman using video electroencephalography (VEEG), electroencephalography source localization, [18F]fluorodeoxyglucose positron emission tomography, magnetic resonance imaging, and psychiatric and neuropsychological assessments and of treating it with stereo electroencephalography-guided radiofrequency (SEEG-RF) ablation. EPC comprised recurrent myoclonus of the right thigh and iliopsoas with a progressive pain syndrome after left anterior-temporo-mesial resection. Switching between VEEG under regular and epidural block helped to define myoclonus as the presenting ictal symptom with a suspected seizure onset zone in the left parietal paramedian lobule. After the epileptic network was identified, SEEG-RF ablation abolished all seizures. No correlation was found between pain and VEEG/SEEG abnormalities. Rehabilitation began 3 days after the SEEG-RF ablation. By 1 year of follow-up, the patient had no EPC and could walk with assistance in rehabilitation; however, due to the abrupt abolishment of EPC and underlying psychological factors, the patient perceived her pain as overriding, which prevented her from walking. The application of SEEG-RF ablation is an efficient therapeutic option for focal EPC with special concerns regarding concurrent nonepileptic pain. https://thejns.org/doi/10.3171/CASE23611.

Narrative review of radiofrequency ablation applications in peripheral nerves.

Chronic pain is a pervasive and often-complex condition that can severely detract from an individual's quality of life. When conservative measures of treatment fail, radiofrequency ablation (RFA) has emerged as a potential alternative. This narrative review subsequently explores recent advancements in the use of RFA on peripheral nerves as a means of attenuating chronic pain and providing relief to patients. A comprehensive literature search was conducted on the PubMed database using the keywords "Radiofrequency", "Ablation", "Pain", "Chronic", "Peripheral", and "Nerve". The search focused on articles published between 2018 to 2023 that discussed an application of RFA in a peripheral nerve. In total, 30 articles were selected for inclusion in this review. Results indicate the successful use of RFA in an array of chronic pain conditions and anatomical sites. Applications include the treatment of trigeminal neuralgia (TN), occipital neuralgia, cluster headaches, knee pain derived from osteoarthritis (OA), hip pain, abdominal pain associated with pancreatic cancer, and several other chronic pain conditions. These findings suggest RFA is a viable option for reducing patient's pain scores and improving quality of life. Future research should build off extensive case reports/series with double-blind, randomized controlled studies to further investigate anecdotal successes.

Application of microwave ablation assisted degradation therapy in surgical treatment of intramedullary chondrosarcoma of extremities

AimClinical diagnosis and surgical treatment of chondrosarcoma (CS) are continuously improving. The purpose of our study is to evaluate the effectiveness of microwave ablation (MWA) assisted degradation therapy in the surgical treatment of intramedullary chondrosarcoma of the extremities, to provide a new reference and research basis for the surgical treatment of CS.MethodsWe recruited 36 patients with intramedullary CS who underwent MWA assisted extended curettage. Preoperative patient demographics and clinical data were recorded. Surgery was independently assisted by a medical team. Patients were followed up strictly and evaluated for oncological prognosis, radiological results, limb joint function, pain, and complications.ResultsWe included 15 men and 21 women (mean age: 43.5 ± 10.1). The average length of the lesion was 8.1 ± 2.5 cm. Based on preoperative radiographic, clinical manifestations, and pathological results of puncture biopsy, 28 patients were preliminarily diagnosed with CS-grade I and eight patients with CS-grade II. No recurrence or metastasis occurred in the postoperative follow-up. The average Musculoskeletal Tumor Society score was 28.8 ± 1.0, significantly better than presurgery. Secondary shoulder periarthritis and abduction dysfunction occurred in early postoperative stage CS of the proximal humerus in some, but returned to normal after rehabilitation exercise. Secondary bursitis occurred at the knee joint in some due to the internal fixation device used in treatment; however, secondary osteoarthritis and avascular necrosis of the femoral head were not observed. Overall, oncological and functional prognoses were satisfactory.ConclusionsThe application of MWA assisted degradation therapy in intramedullary CS can achieve satisfactory oncology and functional prognosis, providing a new option for the limited treatment of CS.

Planar and ridged waveguide preparation on erbium pre-implanted fused silica by multi-energy helium ion implantation and femtosecond laser ablation

Ion implantation stands as a highly competitive technique for fabricating optical waveguide structures within photoelectric materials. In this work, both planar and ridge waveguides have been successfully realized on fused silica. The fabrication process begins with the implantation of erbium ions into fused silica, utilizing an energy of 400 keV and a fluence of 5×1015ions/cm2 to produce a fluorescence effect. Following this, helium ions are implanted at varying energies −450, 500, and 550 keV-with a consistent fluence of 3.2×1016ions/cm2 to create a planar waveguide structure. Subsequently, the ridge waveguide is meticulously prepared through the application of laser ablation, leveraging the pre-existing planar waveguide as a foundation. The guide mode of the planar waveguide is characterized at a wavelength of 632.8 nm using the prism coupling method. Additionally, the near-field light intensity distribution at the same wavelength is assessed via the end-face coupling technique and further analyzed using the finite-difference beam propagation method. To substantiate the practical utility of these waveguides, measurements of the propagation loss and fluorescence properties are conducted.

Radiofrequency Ablation: A Promising Treatment Method for Abdominal Wall Endometriosis.

To evaluate the application of radiofrequency ablation (RFA) as a treatment method for abdominal wall endometriosis (AWE). The characteristics of the AWE lesions in the patients were obtained using ultrasound (US). The patients received general and local anesthesia, and then, AWE lesions were divided into 1 cm3 sections visually, and each of these sections underwent US-guided RFA using the moving shot technique. Follow-up included outpatient appointments, including a US examination 1, 3, and 6 months after the treatment to assess the volume of the lesions. In addition, the level of pain experienced by the patients was measured using a visual analogue scale (VAS) before and the day after the procedure, as well as at each follow-up appointment. Ten patients were treated with RFA. The procedural success was achieved in all of the patients. The median volume of the lesions decreased from 7.3 cm3 (IQR = 4.39,23.75) to 2.95 cm3 (IQR = 1.65,9.09) (P = 0.005). All patients reported reduced pain levels, and the median of their VAS score decreased from 9 (IQR = 8,9) to 0 (IQR = 0,1.25) (P = 0.004) at the end of the follow-up period. None of the patients experienced complications related to RFA treatment. Based on the study's findings, RFA appears to be a promising minimally invasive treatment for AWE. However, larger studies with longer follow-up periods are required for a more comprehensive understanding of its efficacy and safety. Level 4, Case Series.

Can Intracardiac Echocardiography Reduce Steam Pops During Half-Normal Saline Irrigated Radiofrequency Ablation?

Irrigated radiofrequency ablation with half-normal saline can potentially increase lesion size but may increase the risk of steam pops with the risk of emboli or perforation. We hypothesized that pops would be preceded by intracardiac echocardiography (ICE) findings as well as a large impedance fall. In 100 consecutive patients undergoing endocardial ventricular arrhythmia radiofrequency ablation with half-normal saline, we attempted to observe the ablation site with ICE. Radiofrequency ablation power was titrated to a 15 to 20 Ohm impedance fall and could be adjusted for tissue whitening and increasing bubble formation on ICE. Steam pops were defined as audible or a sudden explosion of microbubbles on ICE. Of 2190 ablation applications in 100 patients (82% cardiomyopathy, 50% sustained ventricular tachycardia), pops occurred during 43 (2.0%) applications. Sites with pops had greater impedance decreases of 18 [14, 21]% versus 13 [10, 17]% (P<0.001). ICE visualized 1308 (59.7%) radiofrequency sites, and fewer pops occurred when ICE visualized the radiofrequency ablation site (1.4%) compared with without ICE visualization (2.8%; P=0.016). Of the 18 ICE-visible pops, 7 (39%) were silent but recognized as an explosion of bubbles on ICE. With ICE, 89% of pops were preceded by either tissue whitening or a sudden increase in bubbles. In a multivariable model, tissue whitening and a sudden increase in bubbles were associated with steam pops (odds ratio, 7.186; P=0.004, and odds ratio, 29.93; P<0.001, respectively), independent of impedance fall and power. There were no pericardial effusions or embolic events with steam pops. Steam pops occurred in 2% of half-normal saline radiofrequency applications titrated to an impedance fall and are likely under-recognized without ICE. On ICE, steam pops are usually preceded by tissue whitening or a sudden increase in bubble formation, which can potentially be used to adjust radiofrequency application to help reduce pops.

First experience of focal pulsed field ablation for premature ventricular contractions

Abstract Introduction Pulsed field ablation (PFA) has emerged as a novel strategy to achieve ablation of cardiac tissue. Clinical evidence suggests a remarkable lesion durability and safety profile for AF ablation. Nonetheless, a growing interest exists in broadening its field of application for catheter ablation of ventricular arrhythmias (VA). The CENTAURI system arises as a promising PFA system for targeting VA as it allows pulsed electric field (PEF) delivery via standard, commercially available focal ablation catheters and concomitant coupling with their mapping systems. Purpose To assess, for the first time, the feasibility of focal PFA via the CENTAURI system for premature ventricular complex (PVC) ablation. Methods We conducted a prospective analysis of patients with either high burden (&amp;gt;10%) or symptomatic idiopathic PVC undergoing focal PFA using CENTAURI system at our institution. Procedures were performed between December 2022 and August 2023. Acute and long-term success were defined as no PVC recurrence during a 24h in-hospital monitoring period, and ≥80% burden reduction with absence of symptoms after at least 30 days post-ablation, respectively. PVC monitoring was performed by implantable loop recorder (ILR) or surface ECG Holter monitoring. Results Fourteen patients (age range: 16-87 years; 10 females) were included. Procedures were performed via the CENTAURI system in combination with CARTO 3 system and EnSite X EP system in 4 (28.6%) and 10 cases (71.4%) respectively. Targeted ablation sites were the right ventricular outflow tract (6 cases), right moderator band (2 cases), left postero-medial papillary muscle -PM- (2 cases), and right posterior PM, tricuspid annulus, left posterior fascicle and aortomitral continuity (AMC) in one case. On average, 6.5 applications were delivered to the site of origin with a mean contact force of 11g. Procedural duration and fluoroscopy time were 102 and 8.9 minutes. Two minor complications were observed: one transitory ST depression (solved after i.v. nitrate administration) after repeated applications to AMC, and a femoral pseudoaneurysm. The remaining 12 procedures were uneventful. Although most of the procedures were performed under general anesthesia due to concerns about potential significant muscular contraction, 3 cases (21.4%) were successfully managed with light sedation, without significant muscular contraction nor map shift. Incomplete abolishment of PVC during first 24 h was observed in 2 patients (14.3%). After a median follow-up of 113 days (IQR: 83-188), recurrences were detected in one patient (7.14%). Conclusion Herein we report the feasibility and efficacy of PVC ablation using a focal PEF delivery system (CENTAURI). Furthermore, we describe the possibility of performing PVC ablation with this technology under light sedation, which might be important for minimizing anesthesia impact on PVC burden.Table of characteristicsPVC morphologies

Preparation and Performance of a Fiber Optic Temperature Sensor with Multiple Fluorescence Mechanisms.

The tip of a piece of plastic fiber was dyed with thymol blue to form a temperature probe. The fiber optic sensor was calibrated on a heatboard by comparison with a K-type thermal couple. Fluorescence characteristics including fluorescence intensity, emission bandwidth, peak & barycenter wavelengths, and self-referenced intensity ratio were used to carry the information of environment temperature. Accordingly, more than five temperature sensing functions were retrieved from the fluorescent sensor. Among such functions, the emission band barycenter showed premium precision. Temperature-driven shift of the emission band barycenter has a sensitivity of 0.095nm/K, with a nonlinearity of 2.2%FS, resolution of 4K and repeatability of 1.8%FS. The sensor can find its applications in wearable devices and radiofrequency ablation. Finally in a verification experiment, the sensor was used to monitor the temperature of a microwave oven chamber in real time.

Synthesis of Multifunctional Plasmonic Nanodarts through One‐End Deposition on Gold Nanobipyramids for Tumor Organoid Ablation and Antimicrobial Applications

AbstractPlasmonic nanomaterials with multiple components and designed structures show diverse properties and functions owing to the synergistic effects of the different components. Engineering the compositional and structural complexity of plasmonic nanomaterials is a powerful technique for expanding their range of applications. A facile approach to an unprecedented dart‐like type of nanostructure with AgPd bimetal selectively deposited at one end of Au nanobipyramids, forming AgPd nanodarts, is reported here. The synthetic process involves both galvanic replacement and Ostwald ripening. The morphological evolution of the AgPd nanodarts is thoroughly investigated and the growth mechanism is put forward. The as‐obtained AgPd nanodarts exhibit an outstanding photothermal conversion efficiency and peroxidase activity, which make them powerful for photothermally–catalytically combined tumor organoid ablation. In addition, two types of AgPd nanodart‐derived single‐end nanostructures, AgPd@ZIF‐8, and AgPd@TiO2 nanodarts, are prepared for the first time. The ZIF‐8 and TiO2 shell are preferentially coated at the AgPd end of the AgPd nanodarts, respectively. Both AgPd@ZIF‐8 and AgPd@TiO2 nanodarts show superior antimicrobial activities. The protocol and concept of modulating the structure of the nanodarts in this work can be extended to the development of a new class of plasmonic nanostructures with multifunctionalities.

A Novel Approach for Treating Lipomas: Percutaneous Microwave Ablation Combined with Liposuction.

Lipomas, benign adipose tissue tumors, are a common occurrence but currently, the options for their treatment are limited, with surgical excision being the most frequently used management pathway. This scenario can often lead to unsatisfactory cosmetic results and significant patient discomfort. This paper introduces a novel technique, percutaneous microwave ablation with liposuction, to address these challenges. The innovative procedure aims to enhance patient satisfaction, minimize post-operative discomfort, and improve aesthetic outcomes. The technique involves two key steps: (1) the application of percutaneous microwave ablation to selectively disrupt the lipoma cells, followed by (2) a targeted liposuction procedure to remove the ablated lipoma tissue. Our approach optimizes the removal of the lipoma and preserves the surrounding healthy tissue, reducing the risk of local recurrence and improving the cosmetic result. The use of preoperative ultrasound imaging allows for precise localization and delineation of the lipoma, aiding in the planning and execution of the procedure. This novel approach to lipoma treatment is reliable, associated with minimal morbidity, and consistently yields effective results. Additionally, it provides a new perspective on lipoma management, potentially changing the paradigm of current treatment approaches.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Systematic review and meta-analysis: the efficacy and safety of radiofrequency ablation for early superficial esophageal squamous cell neoplasia

Background and AimEsophageal squamous cell neoplasia (ESCN) is predominant in Asia. Endoscopic mucosal resection and endoscopic submucosal dissection (ESD) have both been recommended worldwide, however the application of endoscopic radiofrequency ablation (RFA) for treatment of early superficial ESCN remains inconclusive. We conducted a meta-analysis to study the effectiveness of RFA for early superficial ESCN.MethodsThree major bibliographic databases were reviewed for the enrollment of case series and cohort trials prior to August 23, 2023. We included adults diagnosed with early superficial ESCN who had been receiving endoscopic RFA or ESD if the treatments were available. Our focus was on the 12-month histological complete response rate (CR) and 3-month histological CR, as well as the acute and late postoperative adverse events (AEs) rate during the at follow-up periods.ResultsNine studies were enrolled for qualitative synthesis of narrative review, with eight trials involving a total of 447 participants for analysis. The pooled 12-month and 3-month histological CR were 0.83 (95% CI, 0.59–0.94, I2 = 80%) and 0.74 (95% CI, 0.67–0.80, I2 = 0%), respectively. As for safety, the acute and late postoperative AEs were 0.11 (95% CI, 0.05–0.26, I2 = 68%) and 0.19 (95% CI, 0.14–0.26, I2 = 0%), respectively. In subgroup analysis, the incidence of bleeding, laceration and perforation after endoscopic RFA showed 0.06, 0.06 and 0.02, respectively. When compared with ESD, RFA showed lower acute AEs and late AEs without any obvious significance.ConclusionsFor early superficial ESCN, endoscopic RFA achieved both higher 12-month complete remission and late complication postoperatively when compared to 3-month histological CR and acute AEs separately, while the stricture was encountered most commonly. The choice between endoscopic RFA and ESD remains inconclusive.

Pressure waveform analysis for occlusion assessment significantly reduces contrast medium use in cryoballoon pulmonary vein isolation

BackgroundPulmonary vein (PV) occlusion is crucial for adequate lesion formation during cryoballoon-guided pulmonary vein isolation (CB-PVI). PV occlusion is usually confirmed by angiographies over the inflated balloon device. The aim of our study was to analyze the safety and efficacy of pressure waveform-based PV occlusion assessment during CB-PVI utilizing a novel fully integrated pressure analysis tool.MethodsConsecutive patients with symptomatic atrial fibrillation (AF) scheduled for CB-PVI were prospectively enrolled for pressure waveform-based PV occlusion assessment. A patient cohort receiving conventional angiographies served as control group. Patients with common PV ostia were excluded.ResultsThe study group consisted of 40 patients (16 females, mean age was 64.5 ± 9.7, 45% persistent AF). The control group consisted of 40 matched patients. All 160 PVs in the study group were successfully isolated without the use of additional venograms confirming PV occlusion. The mean procedure duration was 69 ± 12 min in the study group with a mean fluoroscopy duration of 11.5 ± 4.4 min. The mean contrast medium volume was 22 ± 9 ml in the study group and 36 ± 12 ml in the control group (p = 0.0001). Mean procedure duration, mean balloon temperatures, and mean ablation application durations did not differ significantly between the study and the control group. No periprocedural complications occurred.ConclusionCB-PVI utilizing a fully integrated pressure waveform analysis tool to assess PV occlusion is feasible and safe and significantly reduces the amount of contrast medium without impact on procedural parameters and freedom from arrhythmia recurrence.Graphical