Validation of Irrigated Ablation for Pulmonary Vein Isolation in Patients with Paroxysmal Atrial Fibrillation

概要

論文の詳細を見る
Background: Irrigation catheter (Ir–C) is in the process of spreading, however, various aspects of efficient and safe usage are well-known. Methods: Consecutive 122 patients with drug-resistant, paroxysmal atrial fibrillation who underwent extensive pulmonary vein isolation (PVI) using Ir–C were analyzed. PVI were performed with irrigated radiofrequency energy, maximum temperature of 42 °C, power of 25–35 W with constant 17–30 ml/min saline infusion. Right-sided and left-sided circular lesions on left atrial antrum encircling the ipsilateral PVs were placed, guided by 3-dimensional mapping and double Lasso technique. Results: PVI was achieved in all patients, and no major complications related to Ir–C usage were observed. During one application, mean impedance decrease was 13±6 ohm. In the cases with mean time of less than 40 sec for one application (34.9±3.8 sec, n=71), compared with cases with mean time of more than 40 sec for one application (43.1±2.7 sec, n=51), the number of applications was large (58±14 vs. 48±14, p<0.001), procedure time was longer (69±31 vs. 58±22 min, p<0.05), and fluoroscopic time was longer (37±15 vs. 32±11 min, p<0.05). Conclusions: Ir–C was effective and safety for PVI. Applications within mean time of 40 sec might need additional applications, and consequently increased procedure time and fluoroscopic time.