Feasibility and safety of two French electrode catheters in the performance of electrophysiological studies.

Abstract

The aim of this study was to analyze prospectively the feasibility and safety of using 2 Fr versus 6 Fr standard electrode catheters for diagnostic electrophysiological study. Two hundred and five consecutive patients were randomized to receive the 6 Fr approach (3 quadripolar, 6 Fr, electrode catheters inserted through the left or right femoral vein and placed in the high right atrium, right ventricular apex, and His bundle area) or the 2 Fr approach (3 quadripolar, 2 Fr, electrode catheters inserted through a single, 7 Fr, triple lumen, guiding catheter and positioned at the same sites as the 6 Fr approach). Introduction time was shorter in the 2 Fr group (133.3 +/- 65 s, range 87-669 s) than in the 6 Fr group (242.8 +/- 91.8 s, range 168-1024 s, P < 0.001). The overall fluoroscopy time was longer in the 2 Fr group (141.2 +/- 40.1 s, range 78-312 s) than in the 6 Fr group (126.4 +/- 39.7 s, range 58-341 s, P = 0.009). However in the last 100 patients there was no more difference between the two groups (137.6 +/- 28.2 s vs 128.4 +/- 23.2 s, P = 0.07). There was no significant difference between 2 Fr and 6 Fr groups in the mean atrial (5.9 +/- 2.2 mV, range 2.2-11.3 mV, vs 6.1 +/- 2.3 mV, range 2.4-12.4 mV, P = 0.57) and ventricular (5.6 +/- 2.1 mV, range 1.9-9.7 mV, vs 5.7 +/- 2.2 mV, range 2.3-10.5 mV, P = 0.66) activation potential amplitudes recorded during sinus rhythm, or in the rate of stable His bundle potential recording (P = 0.3), and catheter dislodgment (P = 0.54). The overall number of complications was significantly higher in the 6 Fr group than in the 2 Fr group (29 vs 5, P = 0.001), as well as the number of entry site related complications (3 vs 12, P = 0.02) and catheter manipulation related complications (2 vs 17, P < 0.001). The results of this study show that the use of 2 Fr electrode catheters reduces the rates of entry site and catheter manipulation related complications during EPS. Despite their small size, these catheters allow quick and precise positioning of the electrode.