A circular mapping catheter is not mandatory for isolating pulmonary veins during paroxysmal atrial fibrillation ablatio
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A circular mapping catheter is not mandatory for isolating pulmonary veins during paroxysmal atrial fibrillation ablation with radiofrequency Olivier Xhaët 1 & Olivier Deceuninck 1,2 & Benoit Robaye 1 & Fabien Dormal 1 & Benoit Collet 1 & Véronique Godeaux 1 & Florence Huys 1 & Elisabeth Ballant 1 & Maximilien Gourdin 3 & Dominique Blommaert 1 Received: 17 June 2020 / Accepted: 1 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose In this study, we evaluated the feasibility, efficacy, and safety of radiofrequency ablation of paroxysmal atrial fibrillation (AF) with the use of an ablation catheter only (non-CMC group) by retrospectively comparing its procedural success and recurrence rates at 1 year to ablation performed with the help of a circular mapping catheter (CMC group). Methods We compared the success and recurrence rates between 226 patients and 251 patients who underwent index ablation with and without the use of CMC, respectively. Results Freedom from recurrence was defined as a 1-year absence of AF/atrial tachycardia (AT) episodes > 30 s, beyond the 3month blanking period. There was no significant difference between the number of pulmonary vein isolations, recurrence rate of AF/ AT, and the use of antiarrhythmic drugs after 1 year of ablation. The procedure and fluoroscopy times were lower in the non-CMC group compared with the CMC group (106 ± 33 vs. 125 ± 32 min, p < 0.0001; 2.2 ± 1.9 vs. 2.7 ± 2.3 min, p = 0.0002, respectively). Conclusions Pulmonary vein isolation without the use of a CMC is feasible; moreover, the material costs, procedure time, and radiation exposure were reduced compared with the CMC group. Freedom of recurrence was similar between groups. Optimized use of 3D electro-anatomical mapping systems could reduce the radiation exposure for both the patient and physician. Keywords Atrial fibrillation . Ablation . 3D mapping . Circular mapping catheter . Swing-fall technique
1 Introduction Pulmonary vein isolation (PVI) is the cornerstone for paroxysmal atrial fibrillation (AF) ablation [1, 2]. This procedure can be performed using radiofrequency ablation combined with a three-dimensional (3D) navigation system in order to improve the outcomes and reduce radiation exposure to the patient [3]. The cost of this procedure remains high due to the
use of a navigation ablation catheter with contact force sensor and a circular mapping catheter (CMC) to confirm the PVI [2]. Validation of the PVI could be performed by the ablation catheter. Moreover, the site of reconnection is easily located by simple mapping and/or pacing manoeuvres [4]. In this study, we aimed to evaluate the feasibility, procedural safety, clinical success, and recurrence rates of paroxysmal AF ablation with 3D navigation system and contact force-guided radiofrequency ablation catheter but without the use of CMC.
* Olivier Xhaët [email protected]
2 Methods
1
2.1 Patients characteristics
Department of Cardiology, Université catholique de Louvain, CHU UCL Namur – sit
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