PURPOSE: For patients with symptomatic atrial fibrillation (AF), a curvilinear multi-electrode ablation (MEA) catheter has been reported to be successful to achieve pulmonary vein (PV) isolation. However, this approach has not been compared prospectively with conventional PV isolation (CPVI) using a standard circular mapping catheter and 3D electro-anatomic mapping. In this prospective non-randomized study, we compared the efficacy of these two techniques. METHODS: Of 185 consecutive patients, age 54.6 ± 10.1 years, with symptomatic paroxysmal AF (PAF), 96 patients underwent PV isolation by CPVI and 89 patients underwent MEA to isolate the PVs. CPVI was performed by encircling the left- and right-sided PVs. During MEA, the PV ablation catheter (Medtronic, USA) was used to isolate PVs with duty-cycled radiofrequency energy. RESULTS: The mean procedure time was 171.73 ± 52.87 min for CPVI and 133.25 ± 37.99 min for MEA, respectively (P < 0.001). The mean fluoroscopy time was 31.07 ± 14.97 for CPVI and 30.07 ± 11.45 min for MEA (P = 0.651). At 12 months, 80% of patients who underwent CPVI and 82% of patients who underwent MEA were free of symptomatic PAF off antiarrhythmic drug therapy (P = 0.989). Among the variables of age, gender, duration and frequency of PAF, left ventricular ejection fraction, left atrial size, structural heart disease, and the ablation technique, only an increased left atrial size was an independent predictor of recurrent PAF. Left atrial flutter occurred after CPVI in two patients and after MEA ablation in three patients. CONCLUSION: In patients undergoing catheter ablation for PAF, MEA and CPVI proved equally efficacious.
PURPOSE: For patients with symptomatic atrial fibrillation (AF), a curvilinear multi-electrode ablation (MEA) catheter has been reported to be successful to achieve pulmonary vein (PV) isolation. However, this approach has not been compared prospectively with conventional PV isolation (CPVI) using a standard circular mapping catheter and 3D electro-anatomic mapping. In this prospective non-randomized study, we compared the efficacy of these two techniques. METHODS: Of 185 consecutive patients, age 54.6 ± 10.1 years, with symptomatic paroxysmal AF (PAF), 96 patients underwent PV isolation by CPVI and 89 patients underwent MEA to isolate the PVs. CPVI was performed by encircling the left- and right-sided PVs. During MEA, the PV ablation catheter (Medtronic, USA) was used to isolate PVs with duty-cycled radiofrequency energy. RESULTS: The mean procedure time was 171.73 ± 52.87 min for CPVI and 133.25 ± 37.99 min for MEA, respectively (P < 0.001). The mean fluoroscopy time was 31.07 ± 14.97 for CPVI and 30.07 ± 11.45 min for MEA (P = 0.651). At 12 months, 80% of patients who underwent CPVI and 82% of patients who underwent MEA were free of symptomatic PAF off antiarrhythmic drug therapy (P = 0.989). Among the variables of age, gender, duration and frequency of PAF, left ventricular ejection fraction, left atrial size, structural heart disease, and the ablation technique, only an increased left atrial size was an independent predictor of recurrent PAF. Left atrial flutter occurred after CPVI in two patients and after MEA ablation in three patients. CONCLUSION: In patients undergoing catheter ablation for PAF, MEA and CPVI proved equally efficacious.
Authors: Alex Bittner; Gerold Mönnig; Stephan Zellerhoff; Christian Pott; Julia Köbe; Dirk Dechering; Peter Milberg; Kristina Wasmer; Lars Eckardt Journal: Heart Rhythm Date: 2011-03-30 Impact factor: 6.343
Authors: Thomas Deneke; Kathrin Bünz; Annely Bastian; Marcus Päsler; Helge Anders; Rainer Lehmann; Wolfgang Meuser; Joris R de Groot; Marc Horlitz; Ron Haberkorn; Andreas Mügge; Dong-In Shin Journal: J Cardiovasc Electrophysiol Date: 2010-10-11
Authors: Hakan Oral; Christoph Scharf; Aman Chugh; Burr Hall; Peter Cheung; Eric Good; Srikar Veerareddy; Frank Pelosi; Fred Morady Journal: Circulation Date: 2003-10-13 Impact factor: 29.690
Authors: Rypko Beukema; Willem P Beukema; Hauw T Sie; Anand Ramdat Misier; Peter Paul Delnoy; Arif Elvan Journal: Interact Cardiovasc Thorac Surg Date: 2009-09-17