Efficacy of multi-electrode duty-cycled radiofrequency ablation in patients with paroxysmal and persistent atrial fibrillation

Cardiol J. 2013;20(6):618-25. doi: 10.5603/CJ.2013.0162.

Abstract

Background: Radiofrequency (RF) catheter ablation is a first-line therapy for patients withdrug-refractory atrial fibrillation (AF). Complete isolation of electrical potentials at the ostium of pulmonary vein (PV) is a challenging procedure. There are different techniques and devicesused for PV isolation (PVI). The objective of this study was to evaluate the efficacy and safety of PV ablation catheter (PVAC).

Methods: A total of 67 consecutive patients with paroxysmal and persistent AF were treated with the PVAC. The patients' information were obtained from clinical charts. Follow-up was obtained by one day Holter monitoring at 2, 4, 6, 8, 10 and 12 months after ablation and ECG registration if any symptoms or arrhythmia occurred.

Results: The median follow-up duration was 16 months (IQR: 12-20 months). In the population which was available at follow-up (n = 60), 22 (36.7%) patients were in sustained sinus rhythm (SR) without anti-arrhythmic drugs (AAD). Overall 26 (43.3%) patients were in sustained SR with and without AAD. In the paroxysmal AF group, after a single PVAC ablation procedure (n = 39), 19 (48.7%) patients had sustained SR without AAD. In the persistent AF group (n = 15), after the single PVAC ablation, 2 (13.3%) patients had sustained SR without AAD.

Conclusions: PVI with PVAC is a safe procedure with 48.7% efficacy in patients with paroxysmal AF. The efficacy of PVAC in patients with persistent or long-standing persistent AF is not acceptable.

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / adverse effects
  • Catheter Ablation / instrumentation*
  • Electrocardiography, Ambulatory
  • Equipment Design
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Poland
  • Proportional Hazards Models
  • Pulmonary Veins / physiopathology
  • Pulmonary Veins / surgery*
  • Recurrence
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome