Circumferential pulmonary vein isolation with second-generation multipolar catheter in patients with paroxysmal or persistent atrial fibrillation: Procedural and one-year follow-up results

Spitzer, Stefan G.; Leitz, Patrick; Langbein, Anke; Károlyi, László; Scharfe, Frank; Weinmann, Thomas; Rämmler, Carola; Pott, Christian; Mönnig, Gerold; Eckardt, Lars

doi:10.1016/j.ijcard.2017.04.035

Cited by 15 publications

(12 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The tissue contact was also improved due to 20° tilt to the catheter shaft in PVAC‐Gold . Initial studies comparing platinum and gold PVAC catheters reported the same recurrence rate during follow‐up in both groups . However, in our present study, the performance of PVAC‐Gold seemed to be superior to PVAC‐Platinum.…”

Section: Discussioncontrasting

confidence: 44%

Comparison of efficacy of phased multipolar versus traditional radiofrequency ablation: A prospective, multicenter study (CAPCOST)

Essebag

Azizi

Alipour

et al. 2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Background: Multipolar phased pulmonary vein ablation catheter (PVAC), specifically its secondgeneration (PVAC-Gold), has been associated with reduced procedural time for atrial fibrillation (AF) ablation compared to traditional catheters. We performed this study to compare the efficacy of PVAC with point-by-point radiofrequency (RF) ablation.Methods: This is a multicenter-cohort study (2012)(2013)(2014)(2015)(2016)(2017), involving patients with symptomatic, paroxysmal AF refractory to at least one antiarrhythmic medication. Overall, 230 patients were enrolled to (A) PVAC and (B) control groups. Subanalyses were done for ablations performed with PVAC-Gold, and for ablations performed without left atrial (LA) ablation in addition to pulmonary vein isolation. Electrocardiogram and 48-h Holter monitoring were used to assess patients at 3, 6, 9, and 12 months postablation. Recurrence was defined as any atrial arrhythmia >30 s excluding an initial 3-month blanking period. Results:Freedom from any atrial arrhythmia at 12 months postablation was 35.70% and 52.80% in groups A and B, respectively (P = .01). Freedom from atrial arrhythmia was not significantly different when limiting the PVAC cohort to PVAC-Gold and excluding patients with additional LA ablation (A: 44.30%; B: 44.30%, P = .80). Procedural and ablation time was significantly lower in group A than B. Multivariate regression model showed female gender (odds ratio [OR] = 2.90) and recurrence during blanking period (OR = 6.60) as significant predictors of recurrence. Conclusion:This study suggests that PVAC may achieve less freedom from AF than point-by-point RF; however, efficacy is similar when comparing PVAC-Gold and point-by-point stand-alone PV isolation. PVAC is associated with significantly reduced procedural times for AF ablation.

show abstract

Section: Discussioncontrasting

confidence: 44%

Comparison of efficacy of phased multipolar versus traditional radiofrequency ablation: A prospective, multicenter study (CAPCOST)

Essebag

Azizi

Alipour

et al. 2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…The median procedure time was less than 90 min in the PVI-only groups and 100 min in the PersAF-PVI + CFAE group. Likewise, fluoroscopy time and ablation time were short, confirming the swift procedural characteristics previously reported in smaller trials and registries [6,7,15]. Compared with the reported procedural characteristics of conventional point-by-point ablation [9,10,12,13,16] and to a lesser extent to cryoballoon ablation [8,10,11,13], we found PVAC GOLD to have considerably shorter procedure times, fluoroscopy times and ablation times.…”

Section: Procedural Characteristicssupporting

confidence: 86%

“…Furthermore, additional CFAE ablations with PVAC GOLD or MASC and MAAC in the left atrium did not impact safety outcomes. Previous, mostly small studies on the second-generation PVAC GOLD catheter reported major complications ranging from 0 to 6.5% [6][7][8]15]. More recent and larger studies by Spitzer et al and De Greef et al showed more comparable major complication rates below 2% [15,18].…”

Section: Safety Outcomesmentioning

confidence: 91%

Acute success and safety of the second-generation PVAC GOLD phased RF ablation catheter for atrial fibrillation

Klaver¹,

Wintgens

Wijffels

et al. 2020

J Interv Card Electrophysiol

View full text Add to dashboard Cite

Purpose The second-generation multi-electrode catheter, pulmonary vein ablation catheter (PVAC) GOLD, was designed to improve the delivery of phased radiofrequency energy and reduce procedure times using a 'single-shot' approach for pulmonary vein isolation (PVI), while retaining efficacy and safety. This large registry presents acute success rates and safety outcomes in a daily practice setting. Methods A total of 1017 patients undergoing first-time ablation for atrial fibrillation (AF) using PVAC GOLD were included, 644 patients with paroxysmal AF and 373 patients with non-paroxysmal AF, divided into 175 patients receiving PVI only and 198 patients receiving PVI with additional substrate modification. Results High and comparable percentages of successful PVI could be achieved in all groups (98%, 95% and 99%; p = 0.108). The median total procedure time for all groups was 90 min [70-100]. As expected, the total procedure, ablation and fluoroscopy time were significantly longer in the PVI + substrate modification group compared with the PVI-only cases (all p < 0.001), but not between the PVI-only groups (p = 0.306, p = 0.088, p = 0.233, respectively). A total of 44 complications were observed in 43 patients (4.2%). Major complications were seen in 19 patients (1.87%) and non-major procedure-related complications were seen in 25 patients (2.46%). Complications leaving permanent sequelae were rare and occurred in only four patients (0.39%). Complications did not differ between groups (p = 0.199, p = 0.438, p = 0.240 and p = 0.465 respectively). Conclusion PVAC GOLD performs successful PVI, while reducing procedure times and retaining safety for paroxysmal, persistent and long-standing persistent AF. Safety was unaffected by additional substrate modification.

show abstract

“…The purpose of this study was to characterize and compare PV reconnection patterns at repeat electrophysiological study in patients with AF recurrences after initially successful PVI with phased multielectrode radiofrequency technology (PVAC) or 2nd generation cryoballoon (CB). Both have shown to be safe and effective in PVI procedures [6,7]. While phased RF technology aims to achieve PVI by duty-cycled uni/−bipolar RF energy using a multipolar circumferential catheter, cryoballoon PVI is designed as a true single shot device to create circumferential transmural lesions after transient complete PV occlusion.…”

Section: Introductionmentioning

confidence: 99%

Comparison of pulmonary vein reconnection patterns after multielectrode phased radiofrequency- and cryoballoon ablation of atrial fibrillation

Wieczorek

Sassani²,

Hoeltgen³

2020

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background: Pulmonary vein isolation (PVI) using phased radiofrequency (RF) energy has been shown to be effective in the treatment of atrial fibrillation (AF). Methods: We characterize and compare pulmonary vein (PV) reconnection at repeat ablation in patients with AF after initially successful PVI using phased RF technology (PVAC) or 2nd generation cryoballoon (CB). Eighty five patients undergoing redo PVI using multielectrode PVAC phased RF catheter and 66 patients after CB PVI were enrolled 9.7 ± 3.4 months after the initial ablation procedure. Results: The percentage of patients with PV reconnection(s) was comparably high between both groups (93% PVAC and 92% CB). However, 75% of all PVs and left common trunks (CTs) isolated with PVAC were reconnected, compared with 52% reconnections after CB PVI (p < 0.001). A mean of 2.79 ± 1.2 PVs and CTs/patient were reconnected after PVAC PVI compared with 1.97 ± 0.8 in CB patients, p < 0.0001. No patients in the CB group had 4 reconnected PVs, while this pattern of reconnection was observed in 33% in the PVAC group (p < 0.0001). The percentage of patients in the PVAC group with ≥3 reconnected PVs was significantly higher compared with CB patients (56 patients (66%) vs. 17 patients (26%), p < 0.0001), while the percentage of patients with no PV reconnection was comparably low in PVAC and CB patients (7 and 8%, respectively). CTs were most frequently reconnected after PVAC PVI (94%) and left superior PVs after CB ablation (67%), respectively. Conclusions: The number of patients with recurrent AF and PV reconnection(s) at redo PVI was comparably high between both groups. However, the extent and distribution of PV reconnections was different in many aspects, indicating more stable atrial lesions after CB PVI compared with PVAC technology.

show abstract

Circumferential pulmonary vein isolation with second-generation multipolar catheter in patients with paroxysmal or persistent atrial fibrillation: Procedural and one-year follow-up results

Cited by 15 publications

References 23 publications

Comparison of efficacy of phased multipolar versus traditional radiofrequency ablation: A prospective, multicenter study (CAPCOST)

Comparison of efficacy of phased multipolar versus traditional radiofrequency ablation: A prospective, multicenter study (CAPCOST)

Acute success and safety of the second-generation PVAC GOLD phased RF ablation catheter for atrial fibrillation

Comparison of pulmonary vein reconnection patterns after multielectrode phased radiofrequency- and cryoballoon ablation of atrial fibrillation

Contact Info

Product

Resources

About