Document Detail


Pulmonary vein isolation by duty-cycled bipolar and unipolar radiofrequency energy with a multielectrode ablation catheter.
MedLine Citation:
PMID:  19084796     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary vein (PV) isolation for ablation of atrial fibrillation (AF) remains a complex and lengthy procedure. OBJECTIVE: The purpose of this study was to evaluate the feasibility and safety of a novel multielectrode catheter that delivers duty-cycled bipolar and unipolar radiofrequency (RF) energy. METHODS: Patients eligible for catheter ablation of paroxysmal AF after screening with magnetic resonance imaging and transesophageal echocardiography were included in the study. A decapolar (3-mm electrode, 3-mm spacing, 25-mm diameter), circular, over-the-wire mapping and ablation catheter was deployed in the antrum of each PV. Ablation was performed with 60-second, 60 degrees C applications of duty-cycled bipolar/unipolar RF in a 4:1 ratio simultaneously at all selected electrode pairs until local activity was no longer observed. At 6 months, 7-day Holter monitoring was performed to determine freedom from AF without use of antiarrhythmic drugs. RESULTS: In 98 patients (mean age 59 +/- 9 years), the PV ablation catheter was used for ablation of 369 veins (20 common left antra). All targeted veins (100%) were isolated as confirmed by the absence of potentials in the ostium either by PV ablation catheter or Lasso mapping. Mean number of RF applications was 27 +/- 7, total procedural time 84 +/- 29 minutes, and fluoroscopy time 18 +/- 8 minutes. Follow-up after 6 months without antiarrhythmic drugs showed freedom from AF in 83% of patients. No procedure-related complications were observed. CONCLUSION: PV isolation by duty-cycled bipolar/unipolar low-power RF energy through a circular, decapolar catheter can be achieved safely and efficiently, with good efficacy at 6 months.
Authors:
Lucas V A Boersma; Maurits C E F Wijffels; Hakan Oral; Eric F D Wever; Fred Morady
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-09-04
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  5     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-16     Completed Date:  2009-04-07     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1635-42     Citation Subset:  IM    
Affiliation:
Cardiology Department, St. Antonius Hospital, Nieuwegein, The Netherlands. l.boersma@antonius.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / physiopathology,  surgery*,  ultrasonography
Body Surface Potential Mapping
Catheter Ablation / instrumentation*
Echocardiography, Transesophageal
Equipment Design
Female
Follow-Up Studies
Heart Conduction System / physiopathology,  surgery*
Heart Rate / physiology
Humans
Male
Middle Aged
Pulmonary Veins / surgery*
Retrospective Studies
Treatment Outcome
Comments/Corrections
Comment In:
Heart Rhythm. 2008 Dec;5(12):1643-4   [PMID:  19084797 ]

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


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