The Efficacy and Safety of Open Irrigation Catheter in Pulmonary Vein Isolation for Atrial Fibrillation

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Background: Open irrigation Catheter (OIC) have the advantage of delivering greater power without increasing the temperature of the catheter tip, which can ablate wider and deeper lesions, compared with conventional tip catheter. We study the efficacy and safety of OIC for pulmonary vein isolation (PVI) for atrial fiblillation (AF). Method: Catheter ablation was performed using 3.5 mm OIC (Navistar ThermoCcool) or 8-mm catheter (8MC, Navistar DS). Seventy one consecutive AF patients (60 males, 60.6±15 years, 66 paroxysmal AF, 5 persistent AF) enrolled in the study, and subdivided into two groups, OCI group (n=29) and 8MC group (n=42). PVI was performed with maximum power 35 W at 17 or 30 ml/min of constant saline infusion in OCI group. Result: Isolation of pulmonary vein was achieved in all patients. Fluoroscopy time and the number of energy application have no differerce between two groups (respectively, 144 vs 133 min, p=0.286, 96.8 vs 96.3 p=0.57). The recurrence of AF was significant lower in OIC group compared with 8MC group (48% vs 17%, p=0.0045) during mean 3.5 months follow up period with 2 months blanking period. There was no major complication. However, lung congestion without dyspnea in 3 patients and small cerebral infarction in 1 patient in OIC group after procedure. Conclusion: Although there was a lower rate of AF recurrence with the use of OIC, the setting was associated with increased congestive heart failure due to the volume overload.

The Efficacy and Safety of Open Irrigation Catheter in Pulmonary Vein Isolation for Atrial Fibrillation

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