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Safety and efficacy of pulmonary vein isolation using a circular, open-irrigated mapping and ablation catheter: A multicenter registry.

Authors :
Stabile G
De Ruvo E
Grimaldi M
Rovaris G
Soldati E
Anselmino M
Solimene F
Iuliano A
Sciarra L
Schillaci V
Bongiorni MG
Gaita F
Calò L
Source :
Heart rhythm [Heart Rhythm] 2015 Aug; Vol. 12 (8), pp. 1782-8. Date of Electronic Publication: 2015 May 22.
Publication Year :
2015

Abstract

Background: Pulmonary vein (PV) isolation is the cornerstone of catheter ablation in patients with atrial fibrillation (AF). "Single-shot" ablation devices have been recently engineered.<br />Objectives: We report on the safety and efficacy of a novel ablation catheter for PV isolation in patients with AF.<br />Methods: One hundred eighty consecutive patients (58 ± 10 years, 125 male, 31% with structural heart disease) referred for paroxysmal (140) or persistent (40) AF underwent PV isolation by an open-irrigated mapping and radiofrequency (RF) decapolar ablation catheter in 7 centers. Ablation was guided by electroanatomic mapping, allowing RF energy delivery in the antral region of PVs from 10 irrigated electrodes simultaneously.<br />Results: Mean overall procedure time was 113 ± 53 minutes with a mean fluoroscopy time of 13.1 ± 8.4 minutes. The use of a preablation PV imaging related to a significant reduction in fluoroscopy time (from 14.7 ± 9.7 to 8.7 ± 6.6, P < .001). Mean ablation time was 12.5 ± 5.1 minutes, and 98% of the targeted veins were isolated with a mean of 23.4 ± 6.3 RF pulses per patient. In only 4 patients (2.2%) a single-point ablation strategy was required to achieve PV isolation. One groin hematoma and 1 PV stenosis were reported. During a mean follow-up of 13.9 ± 8.2 months 38 of 140 patients (27%) with paroxysmal AF and 12 of 40 patients (30%) with persistent AF had an atrial arrhythmia relapse (P = .671).<br />Conclusions: In this multicenter registry, irrigated multielectrode RF ablation proved feasible, achieving a high rate of isolated PVs. Procedural and fluoroscopy times and success rates were comparable with other techniques, with a low complication rate.<br /> (Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1556-3871
Volume :
12
Issue :
8
Database :
MEDLINE
Journal :
Heart rhythm
Publication Type :
Academic Journal
Accession number :
26004941
Full Text :
https://doi.org/10.1016/j.hrthm.2015.05.025