Abstract 13002: Combined Circular Multielectrode Catheter and Point-by-Point Ablation is Superior to Point-by-Point Ablation Alone in Eliminating Atrial Fibrillation
Background: Besides conventional point-by-point ablation, novel multielectrode catheters emerge for ablation of atrial fibrillation (AF). We sought to evaluate the clinical utility of a pulmonary vein (PV) isolation approach combining the advantages of both techniques.
Methods and results: 240 consecutive AF patients (60.0±10.9 yrs, 67.5% males, 61.7% paroxysmal) were included. In 120 patients, PV isolation was performed with a multielectrode catheter and completed by conventional point-by-point irrigated-tip catheter ablation (combined ablation group). In 120 patients, PV isolation was performed only with point-by-point irrigated-tip catheter ablation. Complete ablation success defined as freedom from any atrial arrhythmia off antiarrhythmic drugs at 1 year was more frequently observed in the combined ablation group (57.5% versus 43.3%, hazard ratio (HR) 1.72, 95% confidence interval [CI] 1.19-2.48, p=0.004). Also the secondary endpoint “clinical success” (≥90% reduction of AF burden on or off antiarrhythmic drugs) was significantly associated with the combined approach (HR 1.99, CI 1.30-3.05, p=0.001). After multivariable adjustment the rate of complete and clinical success remained significantly higher in the combined ablation group (both P≤0.005). The improvement in outcome was not dependent on the type of AF (P>0.05). The rate of major adverse events and the procedure times did not differ between groups. The radiation exposure, however, was significantly smaller in the combined ablation group.
Conclusions: A combined approach based on PV isolation with a multielectrode catheter completed by conventional point-by-point ablation is superior to point-by-point ablation alone and revealed to be clinically safe. The multielectrode technology might create more continuous ablation lesions.
- © 2012 by American Heart Association, Inc.