Key result
The catheter dragging technique for AF ablation was associated with a lower 3-month recurrence rate of atrial tachyarrhythmias compared to the point-by-point technique (42% vs 69%; P=0.03).
Why the study?
Does the catheter dragging technique reduce early recurrence of atrial tachyarrhythmias compared to the point-by-point technique in patients with drug-refractory AF undergoing RF ablation?
Cohort (n=66)
Does the catheter dragging technique reduce early recurrence of atrial tachyarrhythmias compared to the point-by-point technique in patients with drug-refractory AF undergoing RF ablation?
Absolute Event Rate: 42% vs 69%
p-value: p=0.03
The catheter dragging technique for RF ablation of AF is associated with a lower rate of early atrial tachyarrhythmia recurrence and shorter procedural duration compared to the point-by-point technique.
Dragging technique linked to fewer early recurrences after AF ablation; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: The relationship between the applied techniques and clinical outcomes after radiofrequency (RF) ablation of atrial fibrillation (AF) remains unclear. We compared the results of ablation by RF delivered via a point-by-point versus catheter dragging technique for the treatment of AF. METHODS: This study included 66 patients with drug-refractory AF who underwent circumferential pulmonary vein (PV) ablation. A point-by-point technique was used in 35 (53%) patients (Group I), and catheter dragging technique in the remaining 31 (47%) patients (Group II). If AF persisted or remained inducible after the PV isolation, additional ablation of complex fractionated atrial electrograms and linear ablation were performed. RESULTS: Significantly, fewer RF applications were delivered in Group II than in Group I. The total RF energy duration delivered was comparable between the two groups (P = 0.55). However, the total energy of RF deliveries was significantly greater in Group II than in Group I (P = 0.02). Despite a longer fluoroscopic exposure time (P = 0.01), the total procedural duration was significantly shorter in Group II than in Group I (P = 0.005). Within 3 months after a single ablation procedure, 24 patients (69%) in Group I versus 13 patients (42%) in Group II had ≥1 recurrence(s) of atrial tachyarrhythmias (P = 0.03). A multivariate analysis showed that a point-by-point ablation was the only independent predictor of early atrial tachyarrhythmia recurrences. CONCLUSIONS: The catheter dragging technique for ablation of AF was associated with a lower early recurrence rate of atrial tachyarrhythmias than the point-by-point technique.
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Yokokawa et al. (2010) conducted a cohort in Drug-refractory atrial fibrillation (n=66). Catheter dragging technique vs. Point-by-point technique was evaluated on ≥1 recurrence(s) of atrial tachyarrhythmias within 3 months (p=0.03). The catheter dragging technique for AF ablation was associated with a lower 3-month recurrence rate of atrial tachyarrhythmias compared to the point-by-point technique (42% vs 69%; P=0.03).
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