Cor Vasa 2006, 48(6):227-232 | DOI: 10.33678/cor.2006.068

The effect of experience with catheterization and selection of ablation energy on the development of catheter ablation as a routine method for intermittent and persistent atrial fibrillation

Renáta Nevřalová^*, Martin Fiala, Jan Chovančík, Henryk Szymeczek, Radek Neuwirth, Igor Nykl, Marian Branny

Oddělení kardiologie, Kardiocentrum, Nemocnice Podlesí a. s., Třinec, Česká republika

Aims:
The aim of our study was a retrospective comparison of total and fluoroscopy times, and the number of radiofrequency (RF) energy applications in 3 groups of patients undergoing catheter ablation for intermittent atrial fibrillation (AF).

Methods:
Out of a total of 372 ablation procedures in 282 patients, the first 161 ablation procedures in 161 patients (31 F) aged 54.7 ± 9.7 years were included into the analysis. These patients underwent catheter ablation based on full pulmonary vein isolation using electroanatomically navigated circumferential lesions, possibly complemented by left atrial linear lesions in many patients. For analysis, the patients were divided into 3 groups. Group 1 consisted of 56 patients
(10 F), aged 52.8 ± 9.7 years, in whom the ablation was performed in 2001-2003 using a standard 7 F catheter with a 4-mm tip electrode. In Group 2, the ablation was performed (in 2004) in 53 patients (9 F), aged 54.3 ± 9.9 years, using a 7.5 F catheter with a 3.5-mm cooled-tip electrode and a flow rate of 2 ml/min. In Group 3, the ablation was performed (over the first 9 months of 2005) in 52 patients (12 F), aged 57.1 ± 9.2 years, using a 7.5 F catheter with a 3.5-mm cooled-tip electrode and a flow rate of 5 ml/min.

Results:
A significant decrease was found in total procedure time (mins) between Groups 1 and 2 (280.2 ± 41.9 vs. 262.1 ± 44.5; p = 0.02), and between Groups 2 and 3 (262.1 ± 44.5 vs. 218.1 ± 43.3; p < 0.001); there was also a significant decrease in fluoroscopy time (mins) between Groups 1 and 2 (46 ± 14.8 vs. 35.7 ± 9.1; p < 0.001) and between Groups 2 and 3 (35.7 ± 9.1 vs. 20.7 ± 5.7; p < 0.001).

Conclusion:
The experience gained from performing ablation and advances in the technique of delivery of RF energy led to a significant decrease in total and fluoroscopy times, and allowed performing ablation of AF as the most prevalent arrhythmia in a routine and safe manner.

Keywords: Catheter ablation; Intermittent atrial fibrillation; Electroanatomical mapping and navigation; Procedure time; Fluoroscopy time

Published: June 1, 2006  Show citation