Journal Article

Duty-cycled multi-electrode radiofrequency vs. conventional irrigated point-by-point radiofrequency ablation for recurrent atrial fibrillation: comparative 3-year data

Y. De Greef, I. Buysschaert, B. Schwagten, D. Stockman, R. Tavernier and M. Duytschaever

in EP Europace

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

Volume 16, issue 6, pages 820-825
Published in print June 2014 | ISSN: 1099-5129
Published online January 2014 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eut398
Duty-cycled multi-electrode radiofrequency vs. conventional irrigated point-by-point radiofrequency ablation for recurrent atrial fibrillation: comparative 3-year data

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Aims

Pulmonary vein isolation (PVI) is an accepted treatment to relieve symptoms in patients with atrial fibrillation (AF). We studied 3 year outcome after PVI guided by duty-cycled multi-electrode radiofrequency (RF) ablation (pulmonary vein ablation catheter, PVAC) and provided comparative data to outcome after conventional PVI (CPVI) using mapping with irrigated, point-per-point RF ablation.

Methods and results

One hundred and sixty-one consecutive patients with symptomatic paroxysmal or persistent AF and minimal heart disease underwent PVI (PVAC, n = 79 vs. CPVI, n = 82). Follow-up (with symptom-guided rhythm monitoring) was truncated at 3 years in all patients. Success was defined as freedom of documented arrhythmia after a single procedure and without antiarrhythmic drug treatment (ADT). Baseline characteristics did not differ between both groups. At 3 years follow-up, single-procedure success without ADT was comparable between PVAC and CPVI (65% vs. 55%, P = NS). The majority of recurrences occurred during the first year (PVAC 79% vs. CPVI 70%, P = NS). The annual rate of very late recurrence (i.e. beyond 1 year) was similar in both groups (10.5% vs. 15%, P = NS).

Conclusion

At 3 years follow-up, outcome after PVAC-guided PVI is comparable to conventional isolation by irrigated point-by-point RF ablation. In both strategies, the majority of recurrences occurred in the first year of ablation.

Keywords: Atrial fibrillation; Pulmonary vein isolation; Pulmonary vein ablation catheter; Electro-anatomical mapping system

Journal Article.  3361 words.  Illustrated.

Subjects: Cardiovascular Medicine

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