Catheter Ablation for Paroxysmal Atrial Fibrillation: A Randomized Comparison between Multielectrode Catheter and Point-by-Point Ablation

Abstract

Clinical success rates of PV isolation are similar when using multipolar circular PV ablation catheter and point-by-point ablation with a three-dimensional (3D) navigation system in patients with PAF, and results in shorter procedural and fluoroscopic times with a comparable safety profile.

Learning curve in circular multipolar phased radiofrequency ablation of atrial fibrillation

“…These "single-shot" techniques were designed to create a circular ablation lesion around the PVs after the appropriate positioning of the ablation catheter at the ostium or at the antra of each PV. A number of studies have demonstrated comparable levels of success and safety profile, but shorter procedure times with these simplified methods than with the conventional point-by-point ablation [10][11][12][13].…”

Multielectrode phased radiofrequency ablation compared with point-by-point ablation for pulmonary vein isolation – outcomes in 539 patients

“…In addition, the data confirmed the short fluoroscopy and procedure times with PVAC that have been reported by other investigators in various study settings. 9,10 To our knowledge, the duration of follow-up in our cohort is the longest reported to date for PVAC, particularly in patients with persistent/long-lasting persistent AF. The rates of freedom from PAF after 12 months of follow-up were highly similar to those reported for the technology in a recent meta-analysis.…”

“…5,7,8 However, the number of patients in published reports remains limited; there are few publications that outline experiences with PVAC under conditions of actual care, and comparisons with Carto ® (Biosense Webster, Inc., Diamond Bar, CA, USA) and NavX™ (St Jude Medical, Inc., Saint Paul, MN, USA) are rare. 9,10 In addition, there are few data available on the technology in patients with persistent or long-lasting AF. As with all recent technologies, more studies with long-term follow-up are needed.…”

“…While the differences in our center were greater than some others have reported, 21 the finding of shorter times, especially with respect to fluoroscopy times associated with PVAC, is consistent with the findings from several other investigator teams in different study settings. 9,10,19,22 Differences between the groups at baseline may account for part of the differences observed during the study. However, when analyzed separately, procedure times with PVAC remained shorter for all types of AF.…”

Efficacy of multi-electrode duty-cycled radiofrequency ablation in patients with paroxysmal and persistent atrial fibrillation

“…In other study comparing efficacy of PVAC vs. CARTO procedure AF recurrence was documented in 23% and 29% of patients in the PVAC and CARTO groups, respectively (p = 0.8), they also found significantly shorter procedural and fluoroscopic times in the PVAC group (p < 0.0001) [12].…”