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

Abstract

Background: Radiofrequency (RF) catheter ablation is a first-line therapy for patients with drug-refractory atrial fibrillation (AF). Complete isolation of electrical potentials at the ostium of pulmonary vein (PV) is a challenging procedure. There are different techniques and devicesused for PV isolation (PVI). The objective of this study was to evaluate the efficacy and safety of PV ablation catheter (PVAC).

Methods: A total of 67 consecutive patients with paroxysmal and persistent AF were treated with the PVAC. The patients’ information were obtained from clinical charts. Follow-up was obtained by one day Holter monitoring at 2, 4, 6, 8, 10 and 12 months after ablation and ECG registration if any symptoms or arrhythmia occurred.

Results: The median follow-up duration was 16 months (IQR: 12–20 months). In the population which was available at follow-up (n = 60), 22 (36.7%) patients were in sustained sinus rhythm (SR) without anti-arrhythmic drugs (AAD). Overall 26 (43.3%) patients were in sustained SR with and without AAD. In the paroxysmal AF group, after a single PVAC ablation procedure (n = 39), 19 (48.7%) patients had sustained SR without AAD. In the persistent AF group (n = 15), after the single PVAC ablation, 2 (13.3%) patients had sustained SR without AAD.

Conclusions: PVI with PVAC is a safe procedure with 48.7% efficacy in patients with paroxysmal AF. The efficacy of PVAC in patients with persistent or long-standing persistent AF is not acceptable.