Pulmonary Vein Isolation with a Multi-Electrode Ablation Catheter Using Duly-Cycled Bipolar and Unipolar Radiofrequency Energy

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Background: Traditional catheter ablation of atrial fibrillation (AF) requires long procedure times and high level of operator skill. A multielectrode catheter (PVAC, Ablation Frontier) combining circular mapping and duly cycled bipolar and unipolar radiofrequency energy delivery has been developed to map and isolate the pulmonary veins. Aim: To evaluate the efficacy of PVAC for pulmonary vein isolation in paroxysmal AF ablation. Methods: 50 consecutive patients with paroxysmal AF who had failed at least 1 anti-arrhythmic drug and eligible for catheter ablation were included in the study. All 4 pulmonary veins were isolated and confirmed absence of pulmonary vein potentials with PVAC. At 6 and 12 months 48 hours holter monitoring was performed to determine freedom from AF. Results: All patients had structurally normal hearts with mean duration of AF of 4.75±4.52 years. The mean procedure time was 115.88±33.80 minutes. Mean fluoroscopy time was 38.83±13.24 minutes. Mean number of RF applications were 27.79±13.80 minutes. The mean follow up duration was 19.22±6.67 months. 34 patients completed 12 months follow up and 21 (61.8%) were in sinus rhythm without drugs. No procedure related complication was observed. Conclusions: Pulmonary vein isolation using the PVAC has a success rate of about 61.8% at 1 year.
日本不整脈学会の論文