title: One-year follow-up after irrigated multi-electrode radiofrequency ablation of persistent atrial fibrillation.
abstract: OBJECTIVE
  Irrigated multi-electrode ablation (IMEA) is a novel tool to perform pulmonary vein isolation (PVI). The aim was to compare IMEA with point-by-point radiofrequency (RF) ablation in patients with persistent atrial fibrillation (AF) undergoing PVI.
  
  
  RESULTS
  Forty-nine patients (age 60 ± 9 years, 82% male) were studied. In 24 patients, the IMEA catheter was used in conjunction with an electroanatomic mapping system. Twenty-five patients undergoing RF point-by-point ablation (RF-PVI) served as a control group. Validation of PVI based on the IMEA catheter was performed using a standard circular mapping catheter. Ninety-two of 94 pulmonary veins (PVs) (98%) were isolated using IMEA alone. Procedure time was 125 ± 23 min in the IMEA group and 127 ± 31 min in the RF-PVI group (P = 0.79). Fluoroscopy time was 12.2 (11-16.1) min with IMEA compared with 5.2 (4.1-9.3) min in the RF-PVI group (P < 0.001). Net ablation time was 11.8 (10.2-15.4) min in the IMEA group compared with 33.6 (30.3-40.1) min in the RF-PVI group (P < 0.001). Of 94 PVs presumed to be isolated after IMEA ablation, validation using a standard circular mapping catheter showed persistent PV potentials in 33 PVs (35%), requiring additional IMEA ablation. At 12 months, 16 of 24 patients (67%) in the IMEA group compared with 17 of 25 patients (68%) in RF-PVI group were free from AF (P > 0.99).
  
  
  CONCLUSIONS
  With similar total procedure duration, IMEA-PVI was associated with shorter net ablation time and longer fluoroscopy time. Irrigated multi-electrode ablation recordings were not sufficient to confirm isolation in 35% of PVs. Single-procedure efficacy after 12 months was similar between the two groups.
authors.affiliation: Department of Cardiology/Electrophysiology, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland.
authors.forename: Nikola
authors.initials: N
authors.lastname: Pavlović
authors.affiliation: Department of Cardiology/Electrophysiology, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Sticherling
authors.affiliation: Department of Cardiology/Electrophysiology, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland.
authors.forename: Sven
authors.initials: S
authors.lastname: Knecht
authors.affiliation: Department of Cardiology/Electrophysiology, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland.
authors.forename: Tobias
authors.initials: T
authors.lastname: Reichlin
authors.affiliation: Department of Cardiology/Electrophysiology, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland.
authors.forename: Aline
authors.initials: A
authors.lastname: Mühl
authors.affiliation: Department of Cardiology/Electrophysiology, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland.
authors.forename: Beat
authors.initials: B
authors.lastname: Schaer
authors.affiliation: Department of Cardiology/Electrophysiology, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Osswald
authors.affiliation: Department of Cardiology/Electrophysiology, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland michael.kuehne@usb.ch.
authors.forename: Michael
authors.initials: M
authors.lastname: Kühne
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D002908:Chronic Disease; D004566:Electrodes; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D007507:Therapeutic Irrigation / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome
keywords: Atrial fibrillation; Irrigated multi-electrode ablation; Pulmonary vein isolation; Radiofrequency ablation