| Pulmonary vein isolation by duty-cycled bipolar and unipolar radiofrequency energy with a multielectrode ablation catheter. | |
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MedLine Citation:
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PMID: 19084796 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Lucas V A Boersma; Maurits C E F Wijffels; Hakan Oral; Eric F D Wever; Fred Morady |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-09-04 |
Journal Detail:
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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:
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Created Date: 2008-12-16 Completed Date: 2009-04-07 Revised Date: 2009-10-27 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 1635-42 Citation Subset: IM |
Affiliation:
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Cardiology Department, St. Antonius Hospital, Nieuwegein, The Netherlands. l.boersma@antonius.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Heart Rhythm. 2008 Dec;5(12):1643-4
[PMID:
19084797
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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