Document Detail


Comparison of cooled-tip versus 4-mm-tip catheter in the efficacy of acute ablative tissue injury during circumferential pulmonary vein isolation.
MedLine Citation:
PMID:  19563365     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Although several studies have reported the benefits of cooled-tip ablation for circumferential pulmonary veins isolation (CPVI), the acute change of substrate property and acute PV reconnection have not been well demonstrated. The aim of this study was to compare the cooled-tip with regular 4-mm-tip catheter in acute substrate change after CPVI and long-term efficacy. METHODS AND RESULTS: One hundred and fifty-six patients (115 males, age 53 +/- 12 years) who underwent CPVI for treatment of atrial fibrillation (AF) were included. Group A consisted of 52 patients with cooled-tip ablation, and group B consisted of 104 patients with 4-mm-tip catheter ablation. The bipolar voltage of circumferential lesions was obtained using a 3-dimensional (3D) mapping system (NavX) before and after CPVI. The electrical reconnections of 4 PVs were evaluated 30 minutes after CPVI using a circular catheter. Cooled-tip catheter caused more reduction of the electrical voltage in PV antrum, lower incidence of acute PV reconnection, inducibility of AF, and gap-related atrial tachyarrhythmia (AT). Less number of left atrial (LA) ablation line and ablation applications and less procedure time were found in cooled-tip group compared to 4-mm-tip group. No significant difference in the incidence of pain sensation and complication was observed between the 2 groups. At a 14-month follow-up, the recurrence rate in the cooled-tip group was lower than in the 4-mm group (13.5% vs 33.7%, P = 0.009). CONCLUSION: Cooled-tip catheter has a superior long-term outcome than the 4-mm-tip catheter in CPVI, which may be associated with the efficacy of transmural block and electrical isolation in PV antrum.
Authors:
Shih-Lin Chang; Ching-Tai Tai; Yenn-Jiang Lin; Li-Wei Lo; Ta-Chuan Tuan; Ameya R Udyavar; Yu-Feng Hu; Hsuan-Ming Tsao; Chien-Jun Chang; Wen-Chin Tsai; Shih-Ann Chen
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-26
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  20     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-12     Completed Date:  2010-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1113-8     Citation Subset:  IM    
Affiliation:
Department of Medicine and Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / surgery*
Catheter Ablation / instrumentation,  methods*
Cryosurgery / instrumentation,  methods*
Female
Heart Conduction System / surgery*
Humans
Male
Middle Aged
Pulmonary Veins / surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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