{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T14:37:23Z","timestamp":1791038243152,"version":"4.1.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2009,7,7]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            Electric isolation of the pulmonary veins (PVs) can successfully treat patients with paroxysmal atrial fibrillation. However, it remains technically challenging to identify the left atrial\u2013PV junction and sequentially position the ablation catheter in a point-by-point contiguous fashion to isolate the PVs. In this study, a novel endoscopic ablation system was used to directly visualize and ablate tissue at the left atrial\u2013PV junction with laser energy.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            This study consisted of 2 phases: a short-term (n=9) and long-term (n=11) canine experimental validation phase and a multicenter clinical feasibility phase (n=30 paroxysmal atrial fibrillation patients). After transseptal puncture, the balloon-based endoscopic ablation system was advanced to each PV ostium, and arcs of laser energy (90\u00b0 to 360\u00b0) were projected onto the target left atrial\u2013PV junction. Electric PV isolation was defined with a circular multielectrode catheter. In the short-term preclinical experimental phase, 15 of 17 targeted PVs (88%) were successfully isolated. Pathological examination revealed well-demarcated circumferential lesions with minimal endothelial disruption. In the long-term experiments, 9 of 10 targeted veins (90%) remained persistently isolated (at 4 to 8 weeks). In the clinical phase, 105 of 116 PVs (91%) were successfully isolated. After a single procedure, the 12-month drug-free rate of freedom from atrial fibrillation was 60% (18 of 30 patients). There were no significant PV stenoses, but adverse events included 1 episode of cardiac tamponade, 1 stroke without residual defect, and 1 asymptomatic phrenic nerve palsy.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusion\u2014<\/jats:italic>\n            <\/jats:bold>\n            This study establishes the feasibility of a novel paradigm for AF ablation: direct visualization to guide catheter ablation of the left atrial\u2013PV junction.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.108.840587","type":"journal-article","created":{"date-parts":[[2009,6,23]],"date-time":"2009-06-23T01:56:12Z","timestamp":1245722172000},"page":"12-20","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":126,"title":["Visually-Guided Balloon Catheter Ablation of Atrial Fibrillation"],"prefix":"10.1161","volume":"120","author":[{"given":"Vivek Y.","family":"Reddy","sequence":"first","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr","family":"Neuzil","sequence":"additional","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakis","family":"Themistoclakis","sequence":"additional","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan B.","family":"Danik","sequence":"additional","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Bonso","sequence":"additional","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Rossillo","sequence":"additional","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Raviele","sequence":"additional","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Schweikert","sequence":"additional","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Ernst","sequence":"additional","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Heinz","family":"Kuck","sequence":"additional","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Natale","sequence":"additional","affiliation":[{"name":"From the Mount Sinai School of Medicine, New York (V.Y.R.); Massachusetts General Hospital and Harvard Medical School, Boston (V.Y.R., S.B.D.); Homolka Hospital, Prague, Czech Republic (V.Y.R., P.N.); Umberto Hospital, Venice, Italy (S.T., A.B., A.R., A.R., A.N.); Akron General Medical Center, Akron, Ohio (R.S.); St. Georg Hospital, Hamburg, Germany (S.E., K.-H.K.); and Texas Cardiac Arrhythmia Institute, Austin (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.106.655738"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.04.005"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000047065.49852.8F"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2005.00339.x"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.102.16.1879"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2002.00957.x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2003.02577.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2004.00385.x"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.07.046"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.01.017"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.11.006"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.10.005"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000141369.50476.d3"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000091081.19465.f1"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.104.533190"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000151289.73085.36"},{"key":"e_1_3_2_17_2","first-page":"S284.","volume":"3","year":"2006","unstructured":"Yokoyama K, Nakagawa H, Pitha JV, Lazzara R, Jackman WM. 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In press."}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.108.840587","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T05:56:31Z","timestamp":1715579791000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.108.840587"}},"subtitle":["Experimental Feasibility and First-in-Human Multicenter Clinical Outcome"],"short-title":[],"issued":{"date-parts":[[2009,7,7]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2009,7,7]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.108.840587"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.108.840587","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,7,7]]},"assertion":[{"value":"2009-06-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}