TY - JOUR
T1 - Pulmonary Vein Antral Isolation Using an Open Irrigation Ablation Catheter for the Treatment of Atrial Fibrillation. A Randomized Pilot Study
AU - Kanj, Mohamed H.
AU - Wazni, Oussama
AU - Fahmy, Tamer
AU - Thal, Sergio
AU - Patel, Dimpi
AU - Elay, Claude
AU - Di Biase, Luigi
AU - Arruda, Mauricio
AU - Saliba, Walid
AU - Schweikert, Robert A.
AU - Cummings, Jennifer E.
AU - Burkhardt, J. David
AU - Martin, David O.
AU - Pelargonio, Gemma
AU - Dello Russo, Antonio
AU - Casella, Michela
AU - Santarelli, Pietro
AU - Potenza, Domenico
AU - Fanelli, Raffaele
AU - Massaro, Raimondo
AU - Forleo, Giovanni
AU - Natale, Andrea
PY - 2007/4/17
Y1 - 2007/4/17
N2 - Objectives: We sought to test how catheter ablation using an open irrigation catheter (OIC) compares with standard catheters for pulmonary vein antrum isolation. Background: Open irrigation catheters have the advantage of delivering greater power without increasing the temperature of the catheter tip, which enables deeper and wider lesions without the formation of coagulum on catheters. Methods: Catheter ablation was performed using an 8-mm catheter (8MC) or an OIC. Patients were randomized to 3 groups: 8MC; OIC-1, OIC with a higher peak power (50 W); and OIC-2, OIC with lower peak power (35 W). Results: A total of 180 patients were randomized to the 3 treatment strategies. Isolation of pulmonary vein antra was achieved in all patients. The freedom from atrial fibrillation was significantly greater in the 8MC and OIC-1 groups compared with the OIC-2 group (78%, 82%, and 68%, respectively, p = 0.043). Fluoroscopy time was lower in OIC-1 compared with OIC-2 and 8MC (28 ± 1 min, 53 ± 2 min, and 46 ± 2 min, respectively, p = 0.001). The mean left atrium instrumentation time was lower in the OIC-1 compared with the OIC-2 and 8MC groups (59 ± 3 min, 90 ± 5 min, and 88 ± 4 min, respectively, p = 0.001). However, there was a greater incidence of "pops" in the OIC-1 (100%, 0%, 0%, p < 0.001) along with higher incidences of pericardial effusion (20%, 0%, 0%, p < 0.001) and gastrointestinal complaints (17% in OIC-1, 3% in 8MC, and 5% in OIC-2, p = 0.031). Conclusions: Although there was a decrease in fluoroscopy and left atrium instrumentation time with the use of OIC at higher power, this setting was associated with increased cardiovascular and gastrointestinal complications.
AB - Objectives: We sought to test how catheter ablation using an open irrigation catheter (OIC) compares with standard catheters for pulmonary vein antrum isolation. Background: Open irrigation catheters have the advantage of delivering greater power without increasing the temperature of the catheter tip, which enables deeper and wider lesions without the formation of coagulum on catheters. Methods: Catheter ablation was performed using an 8-mm catheter (8MC) or an OIC. Patients were randomized to 3 groups: 8MC; OIC-1, OIC with a higher peak power (50 W); and OIC-2, OIC with lower peak power (35 W). Results: A total of 180 patients were randomized to the 3 treatment strategies. Isolation of pulmonary vein antra was achieved in all patients. The freedom from atrial fibrillation was significantly greater in the 8MC and OIC-1 groups compared with the OIC-2 group (78%, 82%, and 68%, respectively, p = 0.043). Fluoroscopy time was lower in OIC-1 compared with OIC-2 and 8MC (28 ± 1 min, 53 ± 2 min, and 46 ± 2 min, respectively, p = 0.001). The mean left atrium instrumentation time was lower in the OIC-1 compared with the OIC-2 and 8MC groups (59 ± 3 min, 90 ± 5 min, and 88 ± 4 min, respectively, p = 0.001). However, there was a greater incidence of "pops" in the OIC-1 (100%, 0%, 0%, p < 0.001) along with higher incidences of pericardial effusion (20%, 0%, 0%, p < 0.001) and gastrointestinal complaints (17% in OIC-1, 3% in 8MC, and 5% in OIC-2, p = 0.031). Conclusions: Although there was a decrease in fluoroscopy and left atrium instrumentation time with the use of OIC at higher power, this setting was associated with increased cardiovascular and gastrointestinal complications.
UR - http://www.scopus.com/inward/record.url?scp=34047255063&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34047255063&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2006.12.041
DO - 10.1016/j.jacc.2006.12.041
M3 - Article
C2 - 17433955
AN - SCOPUS:34047255063
SN - 0735-1097
VL - 49
SP - 1634
EP - 1641
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 15
ER -