Ablation of paroxysmal and persistent atrial fibrillation with multielectrode phased radiofrequency duty-cycled catheters: Long-term results from a large cohort of patients

Stefano Nardi, Luigi Argenziano, Riccardo Cappato, Giuseppe De Martino, Cristina Esposito, Mariano Scaglione, Francesco Borrello, Giampiero Maglia

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Catheter ablation is a widely used approach to treat patients with drug refractory paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (CAF). The aim of this analysis was to evaluate the long-term safety and efficacy of the multielectrode/phased radiofrequency (RF)/duty-cycled ablation catheters in the treatment of both PAF and CAF in a large cohort of patients. Methods and results From July 2008 to February 2010, 429 consecutive drug refractory symptomatic patients (mean age 60W12 years old, 58%men, 68%PAF, 32%CAF) were treated. Seventy-five patients had two procedures resulting in a total of 504 procedures (procedure mean time: 62W15min). Following ablation, 4-day continuous Holter monitoring was done every 3 months. Recurrence was defined as any atrial tachyarrhythmia of more than 30 s. At 3 months 97.4% of patients were off antiarrhythmic drugs. During a mean followup of 22W5 months, freedom from AF recurrence was 68.5% (95% CI: 63.8-72.6) and higher for PAF than CAF patients. The risk of AF recurrence in PAF patients increased in the presence of hypertension, dyslipidemia, large left atrial diameter (LAD) and lowejection fraction. ForCAF patients, the risk of AF recurrence increased with larger LAD and lower ejection fraction. Complications that resolved prior to discharge were observed in nine patients (2.1%) with no strokes/transient ischemic attacks (TIAs). Conclusion The ablation of symptomatic PAF and CAF with multielectrode phased radiofrequency/duty-cycled ablation catheters shows long-term safety and effectiveness with relatively short procedure times.

Original languageEnglish
Pages (from-to)879-885
Number of pages7
JournalJournal of Cardiovascular Medicine
Volume14
Issue number12
DOIs
Publication statusPublished - Dec 2013

Fingerprint

Atrial Fibrillation
Catheters
Catheter Ablation
Recurrence
Safety
Ambulatory Electrocardiography
Anti-Arrhythmia Agents
Transient Ischemic Attack
Dyslipidemias
Tachycardia
Pharmaceutical Preparations
Stroke
Hypertension

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Duty-cycled radiofrequency
  • Pulmonary vein isolation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ablation of paroxysmal and persistent atrial fibrillation with multielectrode phased radiofrequency duty-cycled catheters : Long-term results from a large cohort of patients. / Nardi, Stefano; Argenziano, Luigi; Cappato, Riccardo; De Martino, Giuseppe; Esposito, Cristina; Scaglione, Mariano; Borrello, Francesco; Maglia, Giampiero.

In: Journal of Cardiovascular Medicine, Vol. 14, No. 12, 12.2013, p. 879-885.

Research output: Contribution to journalArticle

Nardi, Stefano ; Argenziano, Luigi ; Cappato, Riccardo ; De Martino, Giuseppe ; Esposito, Cristina ; Scaglione, Mariano ; Borrello, Francesco ; Maglia, Giampiero. / Ablation of paroxysmal and persistent atrial fibrillation with multielectrode phased radiofrequency duty-cycled catheters : Long-term results from a large cohort of patients. In: Journal of Cardiovascular Medicine. 2013 ; Vol. 14, No. 12. pp. 879-885.
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abstract = "Background Catheter ablation is a widely used approach to treat patients with drug refractory paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (CAF). The aim of this analysis was to evaluate the long-term safety and efficacy of the multielectrode/phased radiofrequency (RF)/duty-cycled ablation catheters in the treatment of both PAF and CAF in a large cohort of patients. Methods and results From July 2008 to February 2010, 429 consecutive drug refractory symptomatic patients (mean age 60W12 years old, 58{\%}men, 68{\%}PAF, 32{\%}CAF) were treated. Seventy-five patients had two procedures resulting in a total of 504 procedures (procedure mean time: 62W15min). Following ablation, 4-day continuous Holter monitoring was done every 3 months. Recurrence was defined as any atrial tachyarrhythmia of more than 30 s. At 3 months 97.4{\%} of patients were off antiarrhythmic drugs. During a mean followup of 22W5 months, freedom from AF recurrence was 68.5{\%} (95{\%} CI: 63.8-72.6) and higher for PAF than CAF patients. The risk of AF recurrence in PAF patients increased in the presence of hypertension, dyslipidemia, large left atrial diameter (LAD) and lowejection fraction. ForCAF patients, the risk of AF recurrence increased with larger LAD and lower ejection fraction. Complications that resolved prior to discharge were observed in nine patients (2.1{\%}) with no strokes/transient ischemic attacks (TIAs). Conclusion The ablation of symptomatic PAF and CAF with multielectrode phased radiofrequency/duty-cycled ablation catheters shows long-term safety and effectiveness with relatively short procedure times.",
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author = "Stefano Nardi and Luigi Argenziano and Riccardo Cappato and {De Martino}, Giuseppe and Cristina Esposito and Mariano Scaglione and Francesco Borrello and Giampiero Maglia",
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T1 - Ablation of paroxysmal and persistent atrial fibrillation with multielectrode phased radiofrequency duty-cycled catheters

T2 - Long-term results from a large cohort of patients

AU - Nardi, Stefano

AU - Argenziano, Luigi

AU - Cappato, Riccardo

AU - De Martino, Giuseppe

AU - Esposito, Cristina

AU - Scaglione, Mariano

AU - Borrello, Francesco

AU - Maglia, Giampiero

PY - 2013/12

Y1 - 2013/12

N2 - Background Catheter ablation is a widely used approach to treat patients with drug refractory paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (CAF). The aim of this analysis was to evaluate the long-term safety and efficacy of the multielectrode/phased radiofrequency (RF)/duty-cycled ablation catheters in the treatment of both PAF and CAF in a large cohort of patients. Methods and results From July 2008 to February 2010, 429 consecutive drug refractory symptomatic patients (mean age 60W12 years old, 58%men, 68%PAF, 32%CAF) were treated. Seventy-five patients had two procedures resulting in a total of 504 procedures (procedure mean time: 62W15min). Following ablation, 4-day continuous Holter monitoring was done every 3 months. Recurrence was defined as any atrial tachyarrhythmia of more than 30 s. At 3 months 97.4% of patients were off antiarrhythmic drugs. During a mean followup of 22W5 months, freedom from AF recurrence was 68.5% (95% CI: 63.8-72.6) and higher for PAF than CAF patients. The risk of AF recurrence in PAF patients increased in the presence of hypertension, dyslipidemia, large left atrial diameter (LAD) and lowejection fraction. ForCAF patients, the risk of AF recurrence increased with larger LAD and lower ejection fraction. Complications that resolved prior to discharge were observed in nine patients (2.1%) with no strokes/transient ischemic attacks (TIAs). Conclusion The ablation of symptomatic PAF and CAF with multielectrode phased radiofrequency/duty-cycled ablation catheters shows long-term safety and effectiveness with relatively short procedure times.

AB - Background Catheter ablation is a widely used approach to treat patients with drug refractory paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (CAF). The aim of this analysis was to evaluate the long-term safety and efficacy of the multielectrode/phased radiofrequency (RF)/duty-cycled ablation catheters in the treatment of both PAF and CAF in a large cohort of patients. Methods and results From July 2008 to February 2010, 429 consecutive drug refractory symptomatic patients (mean age 60W12 years old, 58%men, 68%PAF, 32%CAF) were treated. Seventy-five patients had two procedures resulting in a total of 504 procedures (procedure mean time: 62W15min). Following ablation, 4-day continuous Holter monitoring was done every 3 months. Recurrence was defined as any atrial tachyarrhythmia of more than 30 s. At 3 months 97.4% of patients were off antiarrhythmic drugs. During a mean followup of 22W5 months, freedom from AF recurrence was 68.5% (95% CI: 63.8-72.6) and higher for PAF than CAF patients. The risk of AF recurrence in PAF patients increased in the presence of hypertension, dyslipidemia, large left atrial diameter (LAD) and lowejection fraction. ForCAF patients, the risk of AF recurrence increased with larger LAD and lower ejection fraction. Complications that resolved prior to discharge were observed in nine patients (2.1%) with no strokes/transient ischemic attacks (TIAs). Conclusion The ablation of symptomatic PAF and CAF with multielectrode phased radiofrequency/duty-cycled ablation catheters shows long-term safety and effectiveness with relatively short procedure times.

KW - Atrial fibrillation

KW - Catheter ablation

KW - Duty-cycled radiofrequency

KW - Pulmonary vein isolation

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