[Catheter ablation of atrial fibrillation. Pulmonary vein isolation by using a new multipolar ablation catheter].

Abstract

Catheter ablation of atrial fibrillation (AF) is an established therapeutical option, particularly in treatment of paroxysmal atrial fibrillation. This paper presents the results of using the PVAC multi-electrode ablation catheter (PVAC®, Medtronic Ablation Frontiers, Carlsbad, CA, USA). In 253 patients with paroxysmal or persistant AF, 1051 pulmonary veins were isolated, including ablation of 34 left common ostia and 1 right common ostium. Except one vein, all pulmonary veins in all patients were successfully isolated. In 23 patients with documented typical atrial flutter, the right atrial isthmus was additionally ablated within the same procedure. Follow-up (FU) visits were performed after 1, 3, 6 and 12 months with 12-lead-ECG, 24h-Holter-ECG and 4-days-Holter ECG. Mean FU was 11 ± 7 months with 1.1 interventions per patient (24 redo cases). During FU, 122 of 181 patients with paroxysmal AF (69%) and 23 of 40 patients with persistant AF (58%) were in stable sinus rhythm (SR) after ablation. 159 (62.8%) patients wer under antiarrhythmic drugs after ablation, 214 (84.5%) patients with additional β-blockers. Total procedure time was 71 ± 19 min, and total fluoroscopy time was 16 ± 6 min. In 3 cases (1.2%) procedure-related complications occured. Pulmonary vein isolation by using the PVAC-ablation catheter is a safe and effective method in treatment of paroxysmal and persistant AF.