P1912Procedural efficacy and 30-day safety of the largest single centre registry for PVAC GOLD pulmonary vein isolation for atrial fibrillation

Background: Pulmonary vein isolation (PVI) is the well-established cornerstone of ablation for atrial fibrillation (AF). As there is no superior technology to date, ease of use, and procedural efficacy and safety are important selection criteria. The second-generation multi-electrode PV Ablation Catheter (PVAC GOLD) consists of a circular array with 9 gold electrodes driven by a phased RF generator. Aim and methods: We aim to summarize the procedural characteristics and safety of the PVAC GOLD catheter in the largest real-world cohort of consecutive patients who underwent index ablation for AF using the PVAC GOLD ablation catheter. Results: Between May 2013 and December 2015 831 patients underwent AF ablation (Age 62±10, 70% male, BMI 27±4, 67% paroxysmal AF, 27% CHA2DS2VASC >2, LA volume index 34±10). In 98% on uninterrupted oral anticoagulation (64% VKA, 34% NOAC). Besides PVI, 15% underwent additional substrate modification using MASC MAAC catheters (PVAC+). The table shows efficacy and safety outcomes. PVAC+ had longer procedure times (84 vs. 106 minutes, p>0.001). Successful PVI was achieved in 97% of patients and in 99% of PVs. The LCPV (4.2%) and RIPV (1.5%) showed higher probability for incomplete isolation. Age >75years (HR 0.21 [0.07–0.64], p=0.006) and BMI >30 (HR 0.47 [0.23 - 0.97], p=0.042) were independent predictors for safety outcomes. Vascular access and bleeding complications did not differ between patients on VKA vs NOAC (p=0.341). On day 1, 98% was discharged.