Journal Article

The effectiveness of a high output/short duration radiofrequency current application technique in segmental pulmonary vein isolation for atrial fibrillation

Brian Nilsson, Xu Chen, Steen Pehrson and Jesper Hastrup Svendsen

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 8, issue 11, pages 962-965
Published in print November 2006 | ISSN: 1099-5129
Published online November 2006 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eul100
The effectiveness of a high output/short duration radiofrequency current application technique in segmental pulmonary vein isolation for atrial fibrillation

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Aims Segmental pulmonary vein (PV) isolation by radiofrequency (RF) catheter ablation has become a curative therapy for atrial fibrillation (AF). However, the long procedure time limits the wide application of this procedure. The aim of the current study was to compare a novel ablation technique with a high power output and short application time vs. a conventional technique using a low power output and long application time.

Methods and results The study included 90 consecutive patients (age 53±10 years; 66 men). Segmental PV isolation was performed by irrigated RF catheter ablation in both groups. In the conventional group (Group 1, 45 patients), the power output was limited to 30 W with a target temperature of 50°C and an RF preset duration of 120 s. In the novel group (Group 2, 45 patients), the maximum power output was preset to 45 W, with a target temperature of 55°C and duration of 20 s. In Group 2, a significant reduction in the PV isolation time (127±57 vs. 94±33 min, P<0.02), mean fluoroscopy time (73±23 vs. 55±16 min, P<0.001), and radiation dose was observed. According to the application time and number, Group 2 showed a reduction in RF application time, but a higher number of RF applications were required for creation of complete PV isolation. During a mean follow-up of 15±7 months, a total of 74% of patients in Group 1 and 76% of patients in Group 2 demonstrated stable SR.

Conclusion Segmental PV isolation using a high power output and short application time is safe and effective in PV isolation in patients with AF. This technique can significantly reduce the procedure and fluoroscopy time compared with a low-power output technique.

Keywords: Atrial fibrillation; Catheter ablation; Pulmonary vein isolation

Journal Article.  2531 words.  Illustrated.

Subjects: Cardiovascular Medicine

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