title: A comparison of open irrigated and non-irrigated tip catheter ablation for pulmonary vein isolation.
abstract: OBJECTIVE
  The relative efficacy and safety of open irrigated tip catheters compared with conventional non-irrigated catheters for pulmonary vein isolation (PVI) is unknown.
  
  
  METHODS
  Forty-eight patients undergoing PVI using an open irrigated tip ablation catheter (Group 1) were compared with a group of 31 historical controls (Group 2). The control group underwent similar procedures using a standard, 4 mm tip, temperature controlled ablation catheter. Electrical mapping with a circular catheter was used to guide segmental radiofrequency ablation at the vein ostia.
  
  
  RESULTS
  At follow-up (3.5+/-3.5 months) after a single procedure 35/48 (73%) patients in Group 1 and 14/31 (45%) in Group 2 were in sinus rhythm (p=0.03). Antiarrhythmic drug use was lower among those in Group 1 maintained in sinus rhythm (9/35 (26%) vs 8/14 (57%), p=0.002). Recurrent atrial fibrillation was more common in Group 2 (28/31 (90%) vs 28/48 (58%) p=0.004). Serious complications were uncommon in both groups.
  
  
  CONCLUSIONS
  Compared with an historical control group, pulmonary vein isolation using open irrigated tip catheters was superior to ablation with conventional 4 mm tip catheters. Patients undergoing ablation with an irrigated tip catheter were less likely to experience symptomatic recurrences of atrial fibrillation or require further therapy for post-procedural arrhythmias.
authors.affiliation: Department of Cardiology, Westmead Hospital and Westmead Private Hospital, Westmead, NSW 2145, Australia. stuartpt@yahoo.com
authors.forename: Stuart P
authors.initials: SP
authors.lastname: Thomas
authors.forename: Gunjan
authors.initials: G
authors.lastname: Aggarwal
authors.forename: Anita C
authors.initials: AC
authors.lastname: Boyd
authors.forename: Yuanzhe
authors.initials: Y
authors.lastname: Jin
authors.forename: David L
authors.initials: DL
authors.lastname: Ross
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D007507:Therapeutic Irrigation; D016896:Treatment Outcome