Key result
Pulmonary vein isolation using a novel irrigated multipolar ablation catheter with reduced power settings achieved a one-year success rate of 70% in paroxysmal atrial fibrillation and 42% in persistent atrial fibrillation.
Why the study?
Does pulmonary vein isolation using a novel irrigated multipolar ablation catheter with reduced power settings prevent arrhythmia recurrence in patients with symptomatic, drug-refractory atrial fibrillation?
Cohort (n=89)
No
Does pulmonary vein isolation using a novel irrigated multipolar ablation catheter with reduced power settings prevent arrhythmia recurrence in patients with symptomatic, drug-refractory atrial fibrillation?
The use of a novel irrigated multipolar ablation catheter with reduced power settings (maximum 20 W for 30 seconds) is safe and achieves a one-year success rate of 70% in paroxysmal AF and 42% in persistent AF.
Should not yet change AF ablation practice; leaves open comparative efficacy versus standard catheters in randomized trials.
The use of a novel irrigated multipolar ablation and mapping catheter for pulmonary vein isolation in patients with atrial fibrillation (AF) has demonstrated reasonable acute success rates and short procedure times, however, long-term outcome data are limited. The aim of this study was to analyze the long-term efficacy of this novel ablation system utilizing a reduced power setting for safety purposes.A total of 89 patients with paroxysmal (63 of 89 patients; 71%) or persistent AF underwent PVI with a reduced power setting of maximum 20 Watts (W) unipolar radiofrequency energy and 30 seconds in duration. In cases of persistent AF, atrial substrate ablation was performed additionally. Follow-up was based on outpatient clinic visits at 3, 6, and 12 months and included 5-day Holter ECGs. All of the 347 identified pulmonary veins were successfully isolated. Mean procedure times in PVI and PVI plus substrate ablation were 102 ± 25 minutes and 126 ± 32 minutes, respectively, applying a mean total radiofrequency time of 14 ± 6 minutes and 19 ± 9 minutes. Mean fluoroscopy time was 17 ± 8 minutes and 18 ± 6 minutes, respectively. Follow-up was available for all 89 patients. At one-year follow-up, 44 (70%) patients with paroxysmal AF and 11 (42%) patients with persistent AF remained in stable sinus rhythm after a singleprocedure and off antiarrhythmic drugs.The use of a novel irrigated multipolar ablation catheter with a reduced power setting is safe and feasible, and demonstrates a one-year success rate of 70% in paroxysmal AF and 42% in persistent AF.
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Shin et al. (2017) conducted a cohort in Atrial fibrillation (n=89). NMARQ irrigated multipolar mapping and ablation catheter was evaluated on Stable sinus rhythm after a single procedure and off antiarrhythmic drugs at 12 months (paroxysmal AF). Pulmonary vein isolation using a novel irrigated multipolar ablation catheter with reduced power settings achieved a one-year success rate of 70% in paroxysmal atrial fibrillation and 42% in persistent atrial fibrillation.
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