Ablation of paroxysmal and persistent atrial fibrillation with multielectrode phased radiofrequency duty-cycled catheters

Nardi, Stefano; Argenziano, Luigi; Cappato, Riccardo; Martino, Giuseppe; Esposito, Cristina; Scaglione, Mariano; Borrello, F; Maglia, Giampiero

doi:10.2459/jcm.0b013e328360931a

Cited by 9 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surgical ablations that de-connect a large part of the posterior left atrium, where many of the sources of the PeAF are located, have also become increasing used owing to their simple approach. Conversely, surgical procedures also are difficult to evaluate, and numerous observational studies of mixed populations without controls used different sources of energy and line combinations [15,17,18]. …”

Section: Discussionmentioning

confidence: 99%

Staged transthoracic approach to persistent atrial fibrillation (TOP-AF): study protocol for a randomized trial

Pragliola

Mastroroberto

Gaudino

et al. 2014

Trials

View full text Add to dashboard Cite

BackgroundPersistent atrial fibrillation frequently shows multiple different electrophysiological mechanisms of induction. This heterogeneity causes a low success rate of single procedures of ablation and a high incidence of recurrence. Surgical ablation through bilateral thoracotomy demonstrates better results after a single procedure. Prospective observational studies in inhomogeneous populations without control groups report a remarkable 90% of success with hybrid or staged procedures of surgical ablation coupled with catheter ablation. In this trial, we will examine the hypothesis that a staged approach involving initial minimally invasive surgical ablation of persistent atrial fibrillation, followed by a second percutaneous procedure in case of recurrence, has a higher success rate than repeated percutaneous procedures.Methods/DesignThis is a controlled (2:1) randomized trial comparing use of a percutaneous catheter with minimally invasive transthoracic surgical ablation of persistent atrial fibrillation. The inclusion and exclusion criteria, definitions, and treatment protocols are those reported by the 2012 Expert Consensus Statement on catheter and surgical ablation of atrial fibrillation. Patients will be randomized to either percutaneous catheter (n = 100) or surgical (n = 50) ablation as the first procedure. After 3 months, they are re-evaluated, according to the same guidelines, and receive a second procedure if necessary. Crossover will be allowed and data analyzed on an “intention-to-treat” basis. Primary outcomes are the incidence of sinus rhythm at 6 and 12 months and the proportions of patients requiring a second procedure.DiscussionThe use of a staged strategy combining surgical and percutaneous approaches might be more favorable in treatment of persistent atrial fibrillation than the controversial single percutaneous ablation.Trial registrationISRCTN08035058 Reg 06.20.2013

show abstract

Section: Discussionmentioning

confidence: 99%

Staged transthoracic approach to persistent atrial fibrillation (TOP-AF): study protocol for a randomized trial

Pragliola

Mastroroberto

Gaudino

et al. 2014

Trials

View full text Add to dashboard Cite

show abstract

“…Recurrence was characterized as any atrial tachyarrhythmia lasting more than 30 seconds. 8 Patients displaying symptoms of irregular heart rhythm or abnormal electrocardiogram (ECG) results underwent a 24-hour Holter monitoring to assess recurrence.…”

Section: Methodsmentioning

confidence: 99%

Concomitant Surgical Ablation for Treatment of Atrial Fibrillation in Patients Undergoing Minimally Invasive Mitral Valve Surgery: A Single-Center Experience in Vietnam

Chuong,

Thuan,

Thanh

et al. 2024

Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Background This study presents the early and midterm outcomes of combining atrial fibrillation (AF) treatment with minimally invasive mitral valve surgery (MIMVS) at our center. Methods From January 2017 to June 2022, our center treated a total of 86 patients with both MIMVS and surgical AF ablation. The patient cohort included 62 women (72.1%) and 24 men (27.9%). The average EuroScore II was 2.64 ± 1.49%, and the patients were followed up for an average period of 46.31 ± 9.84 months. Results Postoperatively, 95.3% of patients experienced a change in sinus rhythm, and 86.2% were discharged in sinus rhythm. The hospital's mortality rate was 2.3%, with a late mortality rate of 3.5%. Survival analysis revealed an atrial fibrillation–free 5-year follow-up rate of 59.1 ± 9.1%. The 5-year survival rate was 92.7 ± 3.3%. Conclusion Our 5-year experience demonstrates that the combination of MIMVS and surgical AF ablation can be routinely performed with favorable peri- and postoperative outcomes. This reflects our hospital's culture and guidance on patient selection, particularly when adopting minimally invasive approaches for multiple procedures.

show abstract

“…AF ablation with the PVAC catheter also shows long-term safety and effectiveness with relatively short procedure times. Among 429 patients (mean age 60±12 years, 58% men, 68% PAF, 32% persistent AF; 75 patients having two procedures; mean procedure time: 62±15 min; 2.1% complication rate), over 22±5 months, freedom from AF recurrence was 68.5% (13). In a smaller study, among 77 with paroxysmal AF submitted to PVAC ablation, after a single procedure at a mean follow-up of 55±11 months, 54/77 (70.1%) patients were free of symptomatic AF (14).…”

Section: Circular Multi-electrode Catheter Techniquementioning

confidence: 99%

Ablation of atrial fibrillation: single-shot techniques poised to dominate rhythm control strategies/the future is here

Manolis¹

2017

J. Thorac. Dis.

View full text Add to dashboard Cite

Over the recent years, the advent of single-shot techniques, such as circular catheter and cryoballoon ablation, has ushered in a new era in the catheter ablation approach and rhythm control strategies of patients with atrial fibrillation (AF). These techniques make it easier to navigate the heart and have the potential to decrease the threshold for, expand the access to, and increase patient and physician acceptance of rhythm-control therapies, that may lead to reduction of the AF disease burden and its socioeconomic impact. Due to technical issues the circular catheter technique is lagging behind, however the cryoballoon approach is progressing at a faster pace both in the field of technical advancements and clinical studies, all contributing to its rapid penetration in the electrophysiological community and rhythm management approaches toward the commonest cardiac arrhythmia. Comparative studies of the conventional point-by-point radiofrequency (RF) ablation technique and the cryoablation approach to pulmonary vein isolation (PVI), which constitutes the cornerstone of all ablation methods, seem to favor the cryoablation technique in certain aspects. The results of current studies converge in their conclusion that cryoablation employing current generation cryoballoons is a simplified and faster method compared to the conventional technique in achieving effective and durable PVI. Furthermore, investigators have recently proposed particular tips and parameters to serve as reliable predictors of successful and durable PVI that may enhance the clinical success of this single-shot ablation technique. These issues will be discussed in this overview and placed into perspective.

show abstract

Ablation of paroxysmal and persistent atrial fibrillation with multielectrode phased radiofrequency duty-cycled catheters

Abstract: The ablation of symptomatic PAF and CAF with multielectrode phased radiofrequency/duty-cycled ablation catheters shows long-term safety and effectiveness with relatively short procedure times.

Cited by 9 publications

References 27 publications

Staged transthoracic approach to persistent atrial fibrillation (TOP-AF): study protocol for a randomized trial

Staged transthoracic approach to persistent atrial fibrillation (TOP-AF): study protocol for a randomized trial

Concomitant Surgical Ablation for Treatment of Atrial Fibrillation in Patients Undergoing Minimally Invasive Mitral Valve Surgery: A Single-Center Experience in Vietnam

Ablation of atrial fibrillation: single-shot techniques poised to dominate rhythm control strategies/the future is here

Contact Info

Product

Resources

About