title: Results of short-term and long-term pulmonary vein isolation for paroxysmal atrial fibrillation using duty-cycled bipolar and unipolar radiofrequency energy.
abstract: BACKGROUND
  Electrical disconnection of the pulmonary veins (PV) plays an important role in the ablation of paroxysmal atrial fibrillation (AF). Antral ablation using a conventional steerable ablation catheter often is technically challenging and time consuming.
  
  
  METHODS
  Eighty-eight patients (mean age 58 +/- 11 years) with symptomatic paroxysmal AF underwent ablation with a circular mapping/ablation decapolar catheter (PVAC). Ablation was performed in the antral region of the PVs with a power-modulated bipolar/unipolar radiofrequency (RF) generator using 8-10 W delivered simultaneously through 2-10 electrodes, as selected by the operator. Seven-day Holter monitor recordings were performed off antiarrhythmic drugs at 3-, 6-, and 12-month follow-up, and patients were requested to visit the hospital in the event of ongoing palpitations. All follow-up patients were divided into 2 groups: Group 1 with a follow-up of less than 1 year and group 2 patients completing a 1-year follow-up.
  
  
  RESULTS
  Overall, 338 of 339 targeted PVs (99%) were isolated with the PVAC with a mean of 24 +/- 9 RF applications per patient, a mean total procedure time of 125 +/- 28 minutes, and a mean fluoroscopy time of 21 +/- 13 minutes. Freedom from AF off antiarrhythmic drugs was found in 82 and 79% of group 1 and group 2 patients, respectively. No procedure-related complications were observed.
  
  
  CONCLUSIONS
  PV isolation by duty-cycled unipolar/bipolar RF ablation can be effectively and safely performed with a circular, decapolar catheter. Twelve-month follow-up data compare favorably with early postablation results, indicating stable effects over time.
authors.affiliation: Department of Electrophysiology, Herzzentrum Duisburg, , Duisburg, Germany. drmwieczorek@t-online.de
authors.forename: Marcus
authors.initials: M
authors.lastname: Wieczorek
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hoeltgen
authors.forename: Elvan
authors.initials: E
authors.lastname: Akin
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Salili
authors.forename: Hakan
authors.initials: H
authors.lastname: Oral
authors.forename: Fred
authors.initials: F
authors.lastname: Morady
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011667:Pulmonary Veins / Q000601:surgery*; D016896:Treatment Outcome