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Artigo Revisado por pares
BIBTEX RIS

Randomized Comparison Between Open Irrigation Technology and Intracardiac‐Echo‐Guided Energy Delivery for Pulmonary Vein Antrum Isolation: Procedural Parameters, Outcomes, and the Effect on Esophageal Injury

2007; Wiley; Volume: 18; Issue: 6 Linguagem: Inglês

10.1111/j.1540-8167.2007.00879.x

ISSN

1540-8167

Autores

Nassir F. Marrouche, Jens Guenther, Nathan M. Segerson, Marcos Daccarett, Harald Rittger, Harald Marschang, V. Schibgilla, Martin Schmidt, Guido Ritscher, Georg Noelker, Johannes Brachmann,

Tópico(s)

Cardiac electrophysiology and arrhythmias

Resumo

Introduction: We performed a prospective study to compare efficacy and safety of both open irrigation tip (OIT) technology with intracardiac echo (ICE)‐guided energy delivery in patients presenting for PVAI. Methods and Results: Fifty‐three patients presenting for PVAI were randomized to ablation using an OIT catheter (Group 1, 26 patients; temperature and power were set at 50° and 50 W, respectively, with a saline pump flow rate of 30 mL/min) or radiofrequency (RF) energy delivery under ICE guidance (Group 2, 27 patients; energy was titrated based on microbubbles formation). The mean procedure time and fluoroscopy exposure were lower in Group 1 (164 ± 42 min and 7,560 ± 2,298 μGraym 2 vs 204 ± 47 min and 12,240 ± 4,356 μGraym 2 ; P = 0.005 and 0.008, respectively). Moreover, the durations of RF lesions applied per PV antrum was lower in Group 1 compared with Group 2 (5.1 ± 2.2 min vs 9.2 ± 3.2 min, P = 0.03, respectively). Within 24 hours after PVAI in 35.7% (all erythema) of Group 1 and 57.1% (21.4% erythema and 35.7% necrosis) of Group 2, patients' esophageal wall changes were documented. After 14 ± 2 months of follow up, recurrences were documented in 19.2% of Group 1 and 22.2% of Group 2 patients. Conclusion: Although both OIT and ICE‐guided energy delivery possess a similar effect in treating AF, OIT seems to be superior in terms of achieving isolation and shortening fluoroscopy exposure. Moreover, a lower incidence of esophageal wall injury was observed utilizing OIT for PVAI.

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