| Title |
A lattice-tip temperature-controlled radiofrequency ablation catheter: durability of pulmonary vein isolation and linear lesion block / |
| Authors |
Reddy, Vivek Y ; Neužil, Petr ; Peichl, Petr ; Račkauskas, Gediminas ; Anter, Elad ; Petru, Jan ; Funasako, Moritoshi ; Minami, Kentaro ; Aidietis, Audrius ; Marinskis, Germanas ; Natale, Andrea ; Nakagawa, Hiroshi ; Jackman, Warren M ; Kautzner, Josef |
| DOI |
10.1016/j.jacep.2020.01.002 |
| Full Text |
|
| Is Part of |
JACC: clinical electrophysiology.. Amsterdam : Elsevier. 2020, vol. 6, iss. 6, p. 623-635.. ISSN 2405-500X |
| Keywords [eng] |
atrial fibrillation ; catheter ablation ; lattice-tip ; temperature-controlled ; pulmonary vein isolation ; mitral isthmus ; roof line ; cavotricuspid Isthmus ; lesion durability |
| Abstract [eng] |
ABSTRACT Background The lattice-tip catheter generates a large thermal footprint during temperature-controlled irrigated radiofrequency ablation. In a first-in-human study, this catheter performed rapid point-by-point pulmonary vein isolation (PVI) and other linear atrial ablations. Objective To evaluate lesion durability upon invasive electrophysiological remapping. Methods In a prospective 3-center single-arm study, paroxysmal or persistent atrial fibrillation patients underwent PVI and, as needed, linear ablation at the cavo-tricuspid isthmus (CTI), mitral isthmus (MI) and/or left atrial roof; no other atrial “substrate” was ablated. Using the lattice catheter and a custom electroanatomical mapping system, temperature-controlled (Tmax 73-80°C; 2-7 sec) point-by-point ablation was performed. Patients were followed for 12 months. Results A total of 65 patients (61.5% paroxysmal / 38.5% persistent) underwent ablation: PVI in 65, MI in 22, LA roof in 24, and CTI in 48 patients. At a median of 108 days after the index procedure, protocol-mandated remapping was performed in 27 patients. The PVs remained durably isolated in all but one reconnected PV – translating to durable isolation in 99.1% of PVs, or 96.3% of patients with all PVs isolated. Of the 47 linear atrial lesions initially placed during the index procedure, durability was observed in 10 of 11 (90.9%) MI lines, all 11 (100%) roof lines, and all 25 (100%) CTI lines. After a median follow-up of 270 days, the 12-month Kaplan-Meier estimate for freedom from atrial arrhythmias was 94.4% ± 3.2%. Conclusions Temperature-controlled lattice-tip point-by-point ablation demonstrated not only highly durable PVI lesion sets, but also durable contiguity of linear atrial lesions. |
| Published |
Amsterdam : Elsevier |
| Type |
Journal article |
| Language |
English |
| Publication date |
2020 |
| CC license |
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