Key result
Use of a novel bidirectional catheter for cardiac arrhythmia ablation resulted in similar acute success rates (96% vs 84%, P=0.151) and procedure duration compared to conventional catheters.
Why the study?
Does the use of an asymmetric bidirectional ablation catheter improve procedural parameters and acute success rates compared to conventional catheters in patients undergoing ablation for cardiac arrhythmias?
Case-Control (n=300)
No
Does the use of an asymmetric bidirectional ablation catheter improve procedural parameters and acute success rates compared to conventional catheters in patients undergoing ablation for cardiac arrhythmias?
The use of a novel asymmetric bidirectional ablation catheter yields similar acute success rates and procedural times compared to conventional catheters, with a potential trend toward shorter procedure duration for atrial tachycardia ablations.
Answers are grounded in this paper and cite their sources.
Comparable success with novel catheter should not change practice; leaves open benefits in randomized trials of atrial tachycardia.
BACKGROUND: The impact of recently introduced asymmetric bidirectional ablation catheters on procedural parameters and acute success rates of ablation procedures is unknown. METHODS: We retrospectively analyzed data regarding ablations using a novel bidirectional catheter in a tertiary cardiac center and compared these in 1:5 ratio with a control group of procedures matched for age, gender, operator, and ablation type. RESULTS: A total of 50 cases and 250 controls of median age 60 (50-68) years were studied. Structural heart disease was equally prevalent in both groups (39%) while history of previous ablations was more common in the study arm (54% vs 30%, P = 0.001). Most of the ablation cases were for atrial fibrillation (46%), followed by atrial tachycardia (28%), supraventricular tachycardia (12%), and ventricular tachycardia (14%). Median procedure duration was 128 (52-147) minutes with the bidirectional, versus 143 (105-200) minutes with the conventional catheter (P = 0.232), and median fluoroscopy time was 17 (10-34) minutes versus 23 (12-39) minutes, respectively (P = 0.988). There was a trend toward a lower procedure duration for the atrial tachycardia ablations, 89 (52-147) minutes versus 130 (100-210) minutes, P = 0.064. The procedure was successfully completed in 96% of the bidirectional versus 84% of the control cases (P = 0.151). A negative correlation was observed between the relative fluoroscopy duration and the case number (r = -0.312, P = 0.028), reflecting the learning curve for the bidirectional catheter. CONCLUSIONS: The introduction of the bidirectional catheter resulted in no prolongation of procedure parameters and similar success rates, while there was a trend toward a lower procedure duration for atrial tachycardia ablations.
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Mantziari et al. (2013) conducted a case-control in Cardiac arrhythmias (n=300). Asymmetric bidirectional ablation catheter vs. Conventional catheter was evaluated on Acute success rate (p=0.151). Use of a novel bidirectional catheter for cardiac arrhythmia ablation resulted in similar acute success rates (96% vs 84%, P=0.151) and procedure duration compared to conventional catheters.
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