Related Experiment Video

Updated: Feb 15, 2026

Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter
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Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter

Published on: June 15, 2015

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REduction of THRomboembolic EVents during Ablation using the laserballoon: The RETHREVA registry

Martin Eichenlaub1,2,3, Arne Pfeufer4, Lars Behrens5

  • 1Isar Heart Center, Munich, Germany.

Journal of Cardiovascular Electrophysiology
|January 10, 2018
PubMed

Insights

Cerebral events (CEs) during laser balloon left atrial catheter ablation (LACA) can be reduced by optimizing the procedure. Using intravenous aspirin and monitoring for aspirin resistance significantly lowers CE incidence.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Background:

  • Cerebral events (CEs), including silent cerebral events (SCEs), are known complications of left atrial catheter ablation (LACA).
  • Laser balloon LACA is a technique used for atrial fibrillation treatment.
  • Reducing the risk of CEs during LACA is crucial for patient safety.

Purpose of the Study:

  • To investigate the incidence of CEs during laser balloon LACA.
  • To identify risk factors for CEs during this procedure.
  • To develop an optimized protocol to minimize CE occurrence.

Main Methods:

  • A prospective registry of 74 patients undergoing laser balloon LACA.
  • Cerebral MRI was used to detect CEs.
  • Patients were stratified into groups based on procedural modifications, including heparin administration timing, transseptal puncture technique, and aspirin use (with aspirin resistance testing).

Main Results:

  • An optimized protocol involving heparin before double transseptal puncture and intravenous aspirin in non-aspirin-resistant patients significantly reduced CE incidence.
  • Larger left atrial diameter and absence of aspirin use were identified as CE risk factors.
  • Aspirin resistance was a strong risk factor for CEs in patients receiving aspirin.

Conclusions:

  • Intravenous aspirin, coupled with ACT-guided heparin and aspirin resistance monitoring, is recommended to reduce CEs during laser balloon LACA.
  • An optimized protocol involving specific procedural steps and aspirin management can significantly lower CE incidence and severity.
Abstract

Keywords:
anticoagulationantiplatelet therapyatrial fibrillationcatheter ablationcerebral eventslaserballoonmagnetic resonance imagingsilent cerebral events

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