A 5-year clinical follow-up after duty-cycled phased RF ablation of paroxysmal atrial fibrillation.

Abstract

Catheter radiofrequency ablation (RFA) is an effective treatment for symptomatic paroxysmal atrial fibrillation (AF). It has been demonstrated that the multielectrode pulmonary vein ablation catheter (PVAC) has favourable outcomes at 6-12months post-ablation, but there are only few studies with a long-term follow-up. We retrospectively reviewed 77 consecutive PVAC procedures in our centre, from November 2007 to December 2012. RFA was attempted in patients with symptomatic paroxysmal AF (mean age 58.7 ± 9.8years, 50 men (64.9%). The ablation strategy consisted of circumferential pulmonary vein isolation (CPVI) with the PVAC system. A questionnaire was used over the follow-up period to assess the efficacy of AF ablation. Success was defined as freedom from AF/atrial flutter or atrial arrhythmia for a period ranging from 3 to 12months or more. Seventy-seven patients were included with paroxysmal AF. The mean duration of the procedure was 99.6 ± 26min and fluoroscopy time 19.4 ± 6.8min. Time of RFA was 22.4 ± 5.8min. Acute complication rate was 10.4% (the most frequent was vascular injury for 6 patients 7.8%, 1 patient presented sepsis (1.3%), 1 patient presented transient ischemic stroke). After a single procedure at a mean FU of 55 ± 11months, 54/77 (70.1%) patients were free of symptomatic AF. These long-term results suggest that PVAC is an efficient system for CPVI of symptomatic paroxysmal AF.