Circumferential Pulmonary Vein Isolation with Second-Generation Multipolar Catheter in Patients with Paroxysmal or Persistent Atrial Fibrillation: Procedural and One-Year Follow-up Results

• Published in: International journal of cardiology Vol. 241; pp. 212 - 217
• Main Authors: Spitzer, Stefan G, Leitz, Patrick, Langbein, Anke, Karolyi, Laszlo, Scharfe, Frank, Weinmann, Thomas, Rämmler, Carola, Pott, Christian, Mönnig, Gerold, Eckardt, Lars
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.08.2017
• Subjects: Aged; Atrial Fibrillation - diagnosis; Atrial Fibrillation - physiopathology; Atrial Fibrillation - surgery; Cardiovascular; Catheter Ablation - methods; Catheter Ablation - trends; Clinical practice; Female; Follow-Up Studies; Humans; Male; Middle Aged; Paroxysmal atrial fibrillation; Persistent atrial fibrillation; Phased radiofrequency ablation; Pilot Projects; Prospective Studies; Pulmonary Veins - surgery; Retrospective Studies; Safety; Time Factors; Treatment Outcome; Phased radiofrequency ablation; Safety; Paroxysmal atrial fibrillation; Clinical practice; Persistent atrial fibrillation
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2017.04.035

Abstract Background There is a lack of procedural and follow-up data on pulmonary vein isolation (PVI) with the second-generation pulmonary vein ablation catheter® (PVAC Gold) in patients with atrial fibrillation (AF). This study provides data on PVI procedures and 1-year follow-up results with PVAC Gold in patients with AF treated in clinical practice. Methods and Results Three hundred and eighty four patients with documented symptomatic paroxysmal (n = 198) or persistent (n = 186) AF were included in a non-randomized prospectively designed database. Patients were enrolled consecutively at 2 high-volume centers. Procedural as well as 1 year follow-up data were systematically analyzed. Average procedure times ± standard deviations were 94 ± 23 min and 97 ± 23 min, respectively, in patients with paroxysmal and persistent AF. Average fluoroscopy times were 14.7 ± 5.4 min and 15.2 ± 5.6 min and total application times 18.1 ± 5.0 min and 18.8 ± 5.2 min, respectively, in the 2 patient cohorts. At 12 months, 70.7% (70/99) and 61.9% (70/113) of patients with paroxysmal and persistent AF, respectively, were free from AF. Four early complications occurred. In the group with persistent AF, 1 posterior cerebral infarction occurred 2 days after the procedure during initiation of anticoagulation. There was no phrenic nerve palsy or esophageal injury associated with the procedures. No thromboembolic events were recorded during follow-up. Conclusions In patients with paroxysmal or persistent AF, second generation multi-electrode-phased radiofrequency ablation delivers favorable mid-term PVI success rates with few procedure-related or follow-up complications.