title: Comparison of ThermoCool® Surround Flow catheter versus ThermoCool® catheter in achieving persistent electrical isolation of pulmonary veins: a pilot study.
abstract: BACKGROUND
  Aim of this study was to compare efficacy and safety of the new ThermoCool Surround Flow® catheter (SFc) versus the ThermoCool® (TCc) in achieving persistent circumferential electrical isolation of the pulmonary veins (PVs) in patients with paroxysmal atrial fibrillation (AF).
  
  
  RESULTS
  This multicenter, randomized, controlled study enrolled patients suffering from paroxysmal AF. Randomization was run in a one-to-one fashion between radiofrequency ablation by TCc or SFc. Aim of PVs ablation was documentation of electrical isolation with exit/entrance block recorded on a circular catheter. Among the 106 enrolled patients, 52 (49.0%) were randomized to TCc and 54 (51.0%) to SFc. Total volume of infused saline solution during the procedure was lower in the SFc than in TCc group (752.7 ± 268.6 mL vs 1,165.9 ± 436.2 mL, P < 0.0001). Number of identified and isolated PVs was similar in the 2 groups. Number of PVs remaining isolated 30 minutes after ablation was higher in the SFc than in TCc group (95.2% vs 90.5%, P < 0.03), mainly driven by acute ablation result in the left PVs (96.1% vs 89.7%, P < 0.04). Complications were seldom and observed only in the TCc group (0% vs 3.84%, P < 0.03). At 6-month follow-up SFc patients reported a trend toward less AF recurrences compared to those in the TCc group (22.9% vs 27.0%, P = 0.69).
  
  
  CONCLUSIONS
  PV isolation by SFc lowered the rate of left PV early reconnections and reduced the volume of infused saline solution while maintaining the safety profile of AF ablation.
authors.affiliation: Civic Hospital, Mirano-Venice, Italy. bertagliaferro@alice.it
authors.forename: Emanuele
authors.initials: E
authors.lastname: Bertaglia
authors.forename: Gaetano
authors.initials: G
authors.lastname: Fassini
authors.forename: Matteo
authors.initials: M
authors.lastname: Anselmino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Stabile
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Grandinetti
authors.forename: Antonio
authors.initials: A
authors.lastname: De Simone
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calò
authors.forename: Claudio
authors.initials: C
authors.lastname: Pandozi
authors.forename: Claudio
authors.initials: C
authors.lastname: Pratola
authors.forename: Franco
authors.initials: F
authors.lastname: Zoppo
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
authors.forename: Assunta
authors.initials: A
authors.lastname: Iuliano
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D062906:Cardiac Catheters; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation*; D016009:Chi-Square Distribution; D022062:Electrophysiologic Techniques, Cardiac; D004867:Equipment Design; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012965:Sodium Chloride / Q000008:administration & dosage; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D012965:Sodium Chloride