Pulmonary vein isolation with the PVAC device resulted in sustained sinus rhythm without anti-arrhythmic drugs in 48.7% of patients with paroxysmal AF and 13.3% with persistent AF.
Cohort (n=67)
No
Does pulmonary vein isolation using the PVAC catheter prevent atrial fibrillation recurrence in patients with paroxysmal and persistent AF?
Pulmonary vein isolation with the PVAC catheter shows moderate efficacy in paroxysmal AF but unacceptably low efficacy in persistent AF, suggesting its use should be limited to paroxysmal cases.
BACKGROUND: Radiofrequency (RF) catheter ablation is a first-line therapy for patients withdrug-refractory atrial fibrillation (AF). Complete isolation of electrical potentials at the ostium of pulmonary vein (PV) is a challenging procedure. There are different techniques and devicesused for PV isolation (PVI). The objective of this study was to evaluate the efficacy and safety of PV ablation catheter (PVAC). METHODS: A total of 67 consecutive patients with paroxysmal and persistent AF were treated with the PVAC. The patients' information were obtained from clinical charts. Follow-up was obtained by one day Holter monitoring at 2, 4, 6, 8, 10 and 12 months after ablation and ECG registration if any symptoms or arrhythmia occurred. RESULTS: The median follow-up duration was 16 months (IQR: 12-20 months). In the population which was available at follow-up (n = 60), 22 (36.7%) patients were in sustained sinus rhythm (SR) without anti-arrhythmic drugs (AAD). Overall 26 (43.3%) patients were in sustained SR with and without AAD. In the paroxysmal AF group, after a single PVAC ablation procedure (n = 39), 19 (48.7%) patients had sustained SR without AAD. In the persistent AF group (n = 15), after the single PVAC ablation, 2 (13.3%) patients had sustained SR without AAD. CONCLUSIONS: PVI with PVAC is a safe procedure with 48.7% efficacy in patients with paroxysmal AF. The efficacy of PVAC in patients with persistent or long-standing persistent AF is not acceptable.
Koźluk et al. (2013) conducted a cohort in Paroxysmal and persistent atrial fibrillation (n=67). Pulmonary vein ablation catheter (PVAC) was evaluated on Sustained sinus rhythm without anti-arrhythmic drugs. Pulmonary vein isolation with the PVAC device resulted in sustained sinus rhythm without anti-arrhythmic drugs in 48.7% of patients with paroxysmal AF and 13.3% with persistent AF.