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.