INTRODUCTION: The acute and long-term outcome of pulmonary vein isolation (PVI) using an endoscopic ablation system (EAS) has only been reported in single-center studies. The current prospective, multicenter study assessed the acute and 1-year outcome following PVI using the EAS. METHODS AND RESULTS: Seventy-two patients (34 female, mean age 58 ± 10 years) with a history (5 ± 6 years) of drug-refractory paroxysmal atrial fibrillation (AF) were included. Endoscopic PVI was performed in all patients. Follow-up was based on regular telephone interviews, Holter ECG, and transtelephonic ECG recordings. Recurrence was defined as a symptomatic and/or documented AF episode >30 seconds following a blanking period of 3 months. In 72 patients, a total of 281 pulmonary veins (PVs) were targeted and 277/281 (98.6%) PVs were isolated successfully using only the EAS. PV stenosis, thrombembolic events, pericardial effusion, pericardial tamponade, and phrenic nerve palsy occurred in 0 of 72, 0 of 72, 3 of 72 (4.2%), 4 of 72 (5.6%), and in 1 of 72 (1.4%) patients, respectively. Sixty-seven of 72 (93.1%) patients completed a follow-up of 365 days and 42 of 67 (62.7%) patients remained in stable sinus rhythm after a single procedure. A total of 13 of 25 (52%) patients suffering from AF recurrence consented to repeat PVI using conventional radiofrequency energy 221 ± 121 days after the index procedure. LA to PV reconduction was found in 30 of 45 (67%) previously isolated PVs. CONCLUSIONS: A very high rate of acute electrical PVI is achieved using exclusively the EAS. The 1-year single-procedure success rate in patients with paroxysmal AF is comparable to conventional PVI. PV reconduction is the major determinant for AF recurrence.
INTRODUCTION: The acute and long-term outcome of pulmonary vein isolation (PVI) using an endoscopic ablation system (EAS) has only been reported in single-center studies. The current prospective, multicenter study assessed the acute and 1-year outcome following PVI using the EAS. METHODS AND RESULTS: Seventy-two patients (34 female, mean age 58 ± 10 years) with a history (5 ± 6 years) of drug-refractory paroxysmal atrial fibrillation (AF) were included. Endoscopic PVI was performed in all patients. Follow-up was based on regular telephone interviews, Holter ECG, and transtelephonic ECG recordings. Recurrence was defined as a symptomatic and/or documented AF episode >30 seconds following a blanking period of 3 months. In 72 patients, a total of 281 pulmonary veins (PVs) were targeted and 277/281 (98.6%) PVs were isolated successfully using only the EAS. PV stenosis, thrombembolic events, pericardial effusion, pericardial tamponade, and phrenic nerve palsy occurred in 0 of 72, 0 of 72, 3 of 72 (4.2%), 4 of 72 (5.6%), and in 1 of 72 (1.4%) patients, respectively. Sixty-seven of 72 (93.1%) patients completed a follow-up of 365 days and 42 of 67 (62.7%) patients remained in stable sinus rhythm after a single procedure. A total of 13 of 25 (52%) patients suffering from AF recurrence consented to repeat PVI using conventional radiofrequency energy 221 ± 121 days after the index procedure. LA to PV reconduction was found in 30 of 45 (67%) previously isolated PVs. CONCLUSIONS: A very high rate of acute electrical PVI is achieved using exclusively the EAS. The 1-year single-procedure success rate in patients with paroxysmal AF is comparable to conventional PVI. PV reconduction is the major determinant for AF recurrence.
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Heart Rhythm Date: 2017-05-12 Impact factor: 6.343
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; José Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: Heart Rhythm Date: 2012-03-01 Impact factor: 6.343
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Europace Date: 2018-01-01 Impact factor: 5.214