Pulmonary vein isolation using a multipolar circular ablation catheter resulted in similar AF recurrence rates compared to point-by-point ablation (23% vs 29%, P=0.8) but shorter procedure times.
RCT (n=102)
Does pulmonary vein isolation using a multipolar circular ablation catheter reduce atrial fibrillation recurrences or procedural times compared to point-by-point ablation in patients with paroxysmal atrial fibrillation?
In patients with paroxysmal atrial fibrillation, pulmonary vein isolation using a multipolar circular ablation catheter achieves similar clinical success rates to point-by-point ablation but significantly reduces procedural and fluoroscopic times.
Absolute Event Rate: 23% vs 29%
p-value: p=0.8
INTRODUCTION: Catheter ablation for paroxysmal atrial fibrillation is widely used for patients with drug-refractory paroxysms of arrhythmia. Recently, novel technologies have been introduced to the market that aim to simplify and shorten the procedure. AIM: To compare the clinical outcome of pulmonary vein (PV) isolation using a multipolar circular ablation catheter (PVAC group), with point-by-point PV isolation using an irrigated-tip ablation catheter and the CARTO mapping system (CARTO group; CARTO, Biosense Webster, Diamond Bar, CA, USA). METHODS: Patients with documented PAF were randomized to undergo PV isolation using PVAC or CARTO. Atrial fibrillation (AF) recurrences were documented by serial 7-day Holter monitoring. RESULTS: One hundred and two patients (mean age 58 ± 11 years, 68 men) were included in the study. The patients had comparable baseline clinical characteristics, including left atrial dimensions and left ventricular ejection fraction, in both study arms (PVAC: n = 51 and CARTO: n = 51). Total procedural and fluoroscopic times were significantly shorter in the PVAC group (107 ± 31 minutes vs 208 ± 46 minutes, P < 0.0001 and 16 ± 5 minutes vs 28 ± 8 minutes, P < 0.0001, respectively). The AF recurrence was documented in 23% and 29% of patients in the PVAC and CARTO groups, respectively (P = 0.8), during the mean follow-up of 200 ± 13 days. No serious complications were noted in both study groups. CONCLUSIONS: Clinical success rates of PV isolation are similar when using multipolar circular PV ablation catheter and point-by-point ablation with a three-dimensional (3D) navigation system in patients with PAF, and results in shorter procedural and fluoroscopic times with a comparable safety profile.
Bulava et al. (Fri,) conducted a rct in Paroxysmal Atrial Fibrillation (n=102). Multipolar circular ablation catheter (PVAC) vs. Point-by-point PV isolation using an irrigated-tip ablation catheter and CARTO mapping system was evaluated on Atrial fibrillation (AF) recurrences (p=0.8). Pulmonary vein isolation using a multipolar circular ablation catheter resulted in similar AF recurrence rates compared to point-by-point ablation (23% vs 29%, P=0.8) but shorter procedure times.