Pulmonary Vein Antral Isolation Using an Open Irrigation Ablation Catheter for the Treatment of Atrial FibrillationA Randomized Pilot Study
Mohamed H. Kanj, MD*,
Oussama Wazni, MD*,
Tamer Fahmy, MD, PhD*,
Sergio Thal, MD*,
Dimpi Patel, MD*,
Claude Elay, MD*,
Luigi Di Biase, MD*, ,
Mauricio Arruda, MD*,
Walid Saliba, MD*,
Robert A. Schweikert, MD*,
Jennifer E. Cummings, MD*,
J. David Burkhardt, MD*,
David O. Martin, MD*,
Gemma Pelargonio, MD ,
Antonio Dello Russo, MD,
Michela Casella, MD,
Pietro Santarelli, MD ,
Domenico Potenza, MD||,
Raffaele Fanelli, MD||,
Raimondo Massaro, MD||,
Giovanni Forleo, MD|| and
Andrea Natale, MD*,*
* Cleveland Clinic, Cleveland, Ohio
University of Insubria, Varese, Italy
Catholic University, Rome, Italy
Catholic University, Campobasso, Italy
|| Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
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Figure 1 Power Titration in the 3 Catheter Groups
(A) Open irrigation catheter using higher power (50 W), (B) open irrigation catheter using lower power (35 W), and (C) 8-mm catheter groups. ET = esophageal temperature; ICE = intracardiac echocardiography.
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Figure 2 Short- and Long-Term Procedural Success
Success was defined as (A) pulmonary vein antrum isolation and (B) freedom of any atrial arrhythmias at 6 months. 8MC = 8-mm catheter; OIC-1 = 3.5-mm open irrigation tip catheter using a higher power and higher irrigation flow rate; OIC-2 = 3.5-mm ThermoCool open irrigation tip catheter using a lower power and lower irrigation flow rate; PVAI = pulmonary vein antrum isolation.
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Figure 3 Time Intervals
(A) Fluoroscopy time, (B) left atrial (LA) instrumentation time, and (C) ablation along the esophagus time in the 3 study groups. Abbreviations as in Figure 2.
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Figure 4 Periprocedural Complications
(A) Incidence of pops during ablation, (B) pericardial effusion, (C) pulmonary edema, and (D) gastrointestinal complaints. Abbreviations as in Figure 2.
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Figure 5 Esophageal Temperature Elevation in the 3 Study Groups
(A) Incidence of ET elevation (%), (B) distribution of ET elevation, (C) postablation rise in ET, (D) time for ET to return to baseline postablation, and (E) postablation ET tracings. RF = radiofrequency; other abbreviations as in Figures 1 and 2.
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