Abstract

Objective The study was to investigate the feasibility and safety of the application of positional reference catheter(PRC) in pulmonary artery(PA) in radiofrequency ablation of atrial fibrillation(AF) by the NavX electroanatomic system compared with the conventional PRC in the coronary sinus (CS). Methods A total of 304 consecutive patients with AF who underwent the first catheter ablation from January 2012 to December 2013 in Cardiology Department of Ningbo First Hospital were randomized into group A (n=152, PRC in PA) or group B (n=152, PRC in CS). Circumferential pulmonary vein isolation were deployed in all subjects while additional complex fractionated electrogram ablation and linear ablation in the roof of LA, mitral isthmus, cavo-tricuspid isthmus as well as superior vena cava or CS if necessary in patients with persistent AF. Results The reconstructive frequency [1-2(1.09±0.28) vs. 1-3(1.18±0.44), P 0.05) and paroxysmal AF cases (80.95% vs. 77.94%, P>0.05) were similar between two groups during the follow-up.But the success rate of persistent AF cases in group A was higher compared with that in group B (75.28% vs. 60.71%, P<0.05). No significant differences existed in complication rates. Conclusion The novel reference technique with catheter in PA may reduce the possibility of model drift and reconstruction, as well as the fluoroscopy exposure and improve the success rate in persistent cases in the radiofrequency ablation of AF guided by the NavX electroanatomic system. Key words: Atrial fibrillation; Radiofrequency ablation; Three-dimensional electroanatomic mapping

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