Use of asymmetric bidirectional catheters with different curvature radius for catheter ablation of cardiac arrhythmias

Pacing Clin Electrophysiol. 2013 Jun;36(6):757-63. doi: 10.1111/pace.12113. Epub 2013 Feb 25.

Abstract

Background: The impact of recently introduced asymmetric bidirectional ablation catheters on procedural parameters and acute success rates of ablation procedures is unknown.

Methods: We retrospectively analyzed data regarding ablations using a novel bidirectional catheter in a tertiary cardiac center and compared these in 1:5 ratio with a control group of procedures matched for age, gender, operator, and ablation type.

Results: A total of 50 cases and 250 controls of median age 60 (50-68) years were studied. Structural heart disease was equally prevalent in both groups (39%) while history of previous ablations was more common in the study arm (54% vs 30%, P = 0.001). Most of the ablation cases were for atrial fibrillation (46%), followed by atrial tachycardia (28%), supraventricular tachycardia (12%), and ventricular tachycardia (14%). Median procedure duration was 128 (52-147) minutes with the bidirectional, versus 143 (105-200) minutes with the conventional catheter (P = 0.232), and median fluoroscopy time was 17 (10-34) minutes versus 23 (12-39) minutes, respectively (P = 0.988). There was a trend toward a lower procedure duration for the atrial tachycardia ablations, 89 (52-147) minutes versus 130 (100-210) minutes, P = 0.064. The procedure was successfully completed in 96% of the bidirectional versus 84% of the control cases (P = 0.151). A negative correlation was observed between the relative fluoroscopy duration and the case number (r = -0.312, P = 0.028), reflecting the learning curve for the bidirectional catheter.

Conclusions: The introduction of the bidirectional catheter resulted in no prolongation of procedure parameters and similar success rates, while there was a trend toward a lower procedure duration for atrial tachycardia ablations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / diagnostic imaging
  • Arrhythmias, Cardiac / epidemiology*
  • Arrhythmias, Cardiac / surgery*
  • Catheter Ablation / instrumentation*
  • Catheter Ablation / statistics & numerical data*
  • Equipment Design
  • Equipment Failure Analysis
  • Female
  • Fluoroscopy / statistics & numerical data*
  • Humans
  • London / epidemiology
  • Male
  • Middle Aged
  • Operative Time*
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome