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Radiofrequency Ablation of Atrial Fibrillation: Nonrandomized Comparison of Circular versus Point‐by‐Point “Smart” Ablation for Achieving Circumferential Pulmonary Vein Isolation and Curing Arrhythmic Symptoms
Author(s) -
ROSSO RAPHAEL,
CHORIN EHUD,
LEVI YUVAL,
ROGOWSKI ORI,
VISKIN SAMI
Publication year - 2016
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13058
Subject(s) - medicine , ablation , pulmonary vein , atrial fibrillation , paroxysmal atrial fibrillation , catheter ablation , cardiology , catheter , radiofrequency ablation , radiofrequency catheter ablation , surgery
Circular vs. “Smart” Ablation of Atrial Fibrillation Introduction Pulmonary vein isolation (PVI) with radiofrequency (RF) ablation is now standard care for atrial fibrillation (AF). New improvements in PVI techniques include use of catheters that measure contact‐force and circular ablation catheters. These techniques have not been compared. Methods and Results We compared the success rate of circumferential pulmonary vein isolation (CPVI) with: (1) “point by point” RF using an irrigated tip ablation catheter with “smart touch” contact‐force; (2) irrigated nMARQ circular ablation catheter in 86 patients with AF. The endpoints of the study were acute and long‐term success rate of CPVI. The 2 groups had similar characteristics: Smart Touch group with 50 patients, age 62 ± 8 years, 64% male; nMARQ group with 36 patients, 75% male, age 58.7 ± 10 years. The type of AF was similar in the 2 groups: paroxysmal and persistent in 68% and 32% in the Navistar group versus 64% and 36% in the nMARQ group. Follow‐up periods were similar (18.4 months vs. 19 months, P = 0.59). All the pulmonary veins were successfully isolated in both groups. However, PVI could not be achieved with the nMARQ in 2.7% of the pulmonary veins ablated and was completed with a Smart Touch. The long‐term success rate was comparable in the 2 groups. Conclusion The nMARQ and Smart Touch catheters give similar results in PVI of both paroxysmal and persistent AF. The procedural time was shorter with the nMARQ in paroxysmal AF. Need for crossover from nMARQ to Smart Touch occurred in 2.7% of PVs ablated.