57072
document
Pulmonary vein re-isolation for atrial fibrillation using duty-cycled phased radiofrequency ablation : safety and efficacy of a primary 2:1 bipolar/unipolar ablation mode . PURPOSE Pulmonary vein isolation ( PVI ) using phased radiofrequency ( RF ) energy has been shown to be effective in the treatment of paroxysmal atrial fibrillation ( AF ) . We characterize pulmonary vein ( PV ) conduction at repeat ablation in patients with AF after an initial successful PVI using phased RF technology and analyze the effects of a primary 2:1 ablation mode . METHODS AND RESULTS A primary 4:1 bipolar/unipolar mode in group A patients ( n = 22 ) was compared with a primary 2:1 mode in group B ( n = 22 ) acutely and during follow-up . Of all PVs , 81 % showed reconnection ( s ) ; 52 % of them had reconnected in all PVs . PVI was achieved in all patients without complications . Procedure and fluoroscopy times were shorter in group B ( 108 ± 15 vs. 126 ± 24 min and 17 ± 5 vs. 23 ± 7 min , respectively ) . This was attributed to a significant decrease of early PV reconnections within the first 30 min in 17 % of group B patients vs. 45 % of group A patients ( p < 0.001 ) . After 9.5 ± 4 months , recurrence of AF was detected in 5 of 22 patients ( 22.7 % ) in group A vs. 3 of 22 patients ( 13.6 % ) in group B ( p = 0.722 ) . CONCLUSIONS Phased RF energy applied by a 2:1 bipolar/unipolar mode seems safe and effective in redo-PVI procedures , resulting in a mid-term freedom from AF in 86.4 % . Significant shorter procedure and fluoroscopy times compared with a primary 4:1 ablation mode during repeat PVI are mainly attributed to a lower incidence of acutely reconnected PVs within the first 30 min .
57073
Intervention_Surgical
duty-cycled phased radiofrequency ablation :
57074
Intervention_Surgical
primary 2:1 bipolar/unipolar ablation mode .
57075
Intervention_Surgical
Pulmonary vein isolation ( PVI )
57076
Intervention_Surgical
phased radiofrequency ( RF ) energy
57077
Intervention_Surgical
pulmonary vein ( PV ) conduction at repeat ablation
57078
Outcome_Other
Procedure and fluoroscopy times