Cooled ablation reduces pulmonary vein isolation time: results of a prospective randomised trial.
Heart
; 95(3): 203-9, 2009 Mar.
Article
em En
| MEDLINE
| ID: mdl-18070948
ABSTRACT
BACKGROUND:
Currently, selection of the ablation catheter for pulmonary vein (PV) isolation is a matter of choice.OBJECTIVE:
To evaluate the efficiency of cooled ablation for PV isolation.METHODS:
A prospective randomised trial was carried out comparing the time required to disconnect each targeted PV using cooled ablation (open irrigation at 15 ml/min, group A) or standard temperature-controlled 4 mm tip catheter ablation (group B). The ablation parameter limit settings were 45 degrees C, 35 (5) W in group A, and 55 degrees C, 35 (5) W in group B.RESULTS:
Thirty-six patients referred for a first atrial fibrillation (AF) ablation procedure were randomised to group A or group B (18 patients in each group). There were no significant differences in baseline characteristics between the groups. Bidirectional block was achieved in 61/61 PVs from group A (100%) and 59/61 PVs from group B (97%); p = NS. Time to PV disconnection was significantly shorter in group A than in group B (median (25th-75th centiles) 14 (5-28) min vs 19 (14-32) min, respectively; p = 0.003). Five asymptomatic PV stenoses were identified by MRI, all in group B (p = 0.05). After 1-year minimum follow-up, AF recurrences were less frequently documented in patients treated with cooled ablation (6% vs 33%; p = 0.05).CONCLUSION:
Cooled ablation is more efficient than standard ablation in achieving PV isolation. Results obtained from this study also suggest a potential benefit of clinical efficacy and safety from cooled ablation, which should be further evaluated in larger clinical trials.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veias Pulmonares
/
Fibrilação Atrial
/
Ablação por Cateter
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
Limite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Heart
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Espanha
País de publicação:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM