title: Safety of pulmonary vein isolation and left atrial complex fractionated atrial electrograms ablation for atrial fibrillation with phased radiofrequency energy and multi-electrode catheters.
abstract: OBJECTIVE
  Recently, a multi-electrode catheter system using phased radiofrequency (RF) energy was developed specifically for atrial fibrillation (AF) ablation: the pulmonary vein ablation catheter (PVAC), the multi-array septal catheter (MASC), and the multi-array ablation catheter (MAAC). Initial results of small trials have been promising: shorter procedure times and low adverse event rates. In a large single-centre registry, we evaluated the adverse events associated with multi-electrode ablation catheter procedures with PVAC alone, or combined with MASC and MAAC.
  
  
  RESULTS
  In all, 634 consecutive patients with AF had 663 procedures with multi-electrode ablation catheters, 502 patients with the PVAC alone, 128 patients with PVAC/MASC/MAAC, 29 redo procedures with the PVAC or PVAC/MASC/MAAC, and 4 patients had a complicated transseptal puncture. Major and minor adverse events during 6 month follow-up were registered. In 15 cases (2.3%), major adverse events were seen within the first month after the procedure. These included complicated transseptal puncture (4), stroke (2), transient ischaemic attack (5), acute coronary syndrome (2), femoral pseudoaneurysm (1), and arteriovenous fistulae (1). Minor adverse events were seen in 10.7% at 6 months, mostly due to femoral haematoma (3.9%), and non-significant PV stenosis (5.2%). There was no difference in the occurrence of major adverse events between PVAC alone, or PVAC/MASC/MAAC ablation.
  
  
  CONCLUSIONS
  Ablation with phased RF and multi-electrode catheters is accompanied by a major adverse event rate of 2.3% within 1 month and a minor event rate of 10.7% at 6 months.
authors.affiliation: Department of Cardiology, St Antonius Hospital, PO Box 2500, 3430 EM Nieuwegein, The Netherlands. a.mulder@antoniusziekenhuis.nl
authors.forename: Anton A W
authors.initials: AA
authors.lastname: Mulder
authors.forename: Jippe C
authors.initials: JC
authors.lastname: Balt
authors.forename: Maurits C E F
authors.initials: MC
authors.lastname: Wijffels
authors.forename: Eric F D
authors.initials: EF
authors.lastname: Wever
authors.forename: Lucas V A
authors.initials: LV
authors.lastname: Boersma
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000209:etiology; D001164:Arteriovenous Fistula / Q000209:etiology; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D022062:Electrophysiologic Techniques, Cardiac / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006406:Hematoma / Q000209:etiology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D011668:Pulmonary Veno-Occlusive Disease / Q000209:etiology; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome; D018658:Ventricular Septal Rupture / Q000209:etiology