Predictors of recurrence following catheter ablation of atrial fibrillation using an irrigated-tip ablation catheter

Chandrasekhar R. Vasamreddy, Lars Lickfett, Vinod K. Jayam, Khurram Nasir, David J. Bradley, Zayd Eldadah, Timm Dickfeld, Ronald D Berger, Hugh Calkins

Research output: Contribution to journalArticle

Abstract

Introduction: The aims of this study were to identify predictors of recurrence after catheter ablation of atrial fibrillation (AF) and to report the safety and efficacy of catheter ablation of AF using an irrigated-tip ablation catheter. Methods and Results: Seventy-five consecutive patients (51 men [68%]; age 54 ± 13 years) with symptomatic drug-refractory paroxysmal (42 patients), persistent (21 patients), or permanent (12 patients) AF underwent catheter ablation of AF using an irrigated-tip ablation catheter and a standard ablation strategy, which involved electrical isolation of all pulmonary veins (PVs) and creation of a cavotricuspid linear lesion. At 10.5 ± 7.5 months of follow-up following a single (n = 75) or redo ablation procedure (n = 11), 39 (52%) of the 75 patients were free of AF, 10 were improved (1.3%), and 26 had experienced no benefit from the ablation procedure (35%). Seventy-six percent of patients with paroxysmal AF were free from recurrent AF. The most significant complications were two episodes of pericardial tamponade, mitral valve injury in one patient, two strokes, and complete but asymptomatic PV stenosis in one patient. Cox proportional hazards multivariate regression analysis identified the presence of persistent AF, permanent AF, and age >50 years prior to the ablation are the only independent predictors of AF recurrence after the first PV isolation procedure. Conclusion: Catheter ablation of AF using a strategy involving isolation of all PVs and creation of a linear lesion in the cavotricuspid isthmus using cooled radiofrequency energy is associated with moderate efficacy and an important risk for complications. The best results of this procedure are achieved in the subset of patients who are younger than 50 years and have only paroxysmal AF.

Original languageEnglish (US)
Pages (from-to)692-697
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume15
Issue number6
DOIs
StatePublished - Jun 2004

Fingerprint

Catheter Ablation
Atrial Fibrillation
Recurrence
Pulmonary Veins
Cardiac Tamponade
Mitral Valve
Multivariate Analysis
Stroke
Regression Analysis

Keywords

  • Atrial fibrillation
  • Atrium
  • Irrigated-tip catheter ablation
  • Pulmonary vein

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Predictors of recurrence following catheter ablation of atrial fibrillation using an irrigated-tip ablation catheter. / Vasamreddy, Chandrasekhar R.; Lickfett, Lars; Jayam, Vinod K.; Nasir, Khurram; Bradley, David J.; Eldadah, Zayd; Dickfeld, Timm; Berger, Ronald D; Calkins, Hugh.

In: Journal of Cardiovascular Electrophysiology, Vol. 15, No. 6, 06.2004, p. 692-697.

Research output: Contribution to journalArticle

Vasamreddy, Chandrasekhar R. ; Lickfett, Lars ; Jayam, Vinod K. ; Nasir, Khurram ; Bradley, David J. ; Eldadah, Zayd ; Dickfeld, Timm ; Berger, Ronald D ; Calkins, Hugh. / Predictors of recurrence following catheter ablation of atrial fibrillation using an irrigated-tip ablation catheter. In: Journal of Cardiovascular Electrophysiology. 2004 ; Vol. 15, No. 6. pp. 692-697.
@article{f73da6e288da4ba78d5d384058fa0ddb,
title = "Predictors of recurrence following catheter ablation of atrial fibrillation using an irrigated-tip ablation catheter",
abstract = "Introduction: The aims of this study were to identify predictors of recurrence after catheter ablation of atrial fibrillation (AF) and to report the safety and efficacy of catheter ablation of AF using an irrigated-tip ablation catheter. Methods and Results: Seventy-five consecutive patients (51 men [68{\%}]; age 54 ± 13 years) with symptomatic drug-refractory paroxysmal (42 patients), persistent (21 patients), or permanent (12 patients) AF underwent catheter ablation of AF using an irrigated-tip ablation catheter and a standard ablation strategy, which involved electrical isolation of all pulmonary veins (PVs) and creation of a cavotricuspid linear lesion. At 10.5 ± 7.5 months of follow-up following a single (n = 75) or redo ablation procedure (n = 11), 39 (52{\%}) of the 75 patients were free of AF, 10 were improved (1.3{\%}), and 26 had experienced no benefit from the ablation procedure (35{\%}). Seventy-six percent of patients with paroxysmal AF were free from recurrent AF. The most significant complications were two episodes of pericardial tamponade, mitral valve injury in one patient, two strokes, and complete but asymptomatic PV stenosis in one patient. Cox proportional hazards multivariate regression analysis identified the presence of persistent AF, permanent AF, and age >50 years prior to the ablation are the only independent predictors of AF recurrence after the first PV isolation procedure. Conclusion: Catheter ablation of AF using a strategy involving isolation of all PVs and creation of a linear lesion in the cavotricuspid isthmus using cooled radiofrequency energy is associated with moderate efficacy and an important risk for complications. The best results of this procedure are achieved in the subset of patients who are younger than 50 years and have only paroxysmal AF.",
keywords = "Atrial fibrillation, Atrium, Irrigated-tip catheter ablation, Pulmonary vein",
author = "Vasamreddy, {Chandrasekhar R.} and Lars Lickfett and Jayam, {Vinod K.} and Khurram Nasir and Bradley, {David J.} and Zayd Eldadah and Timm Dickfeld and Berger, {Ronald D} and Hugh Calkins",
year = "2004",
month = "6",
doi = "10.1046/j.1540-8167.2004.03538.x",
language = "English (US)",
volume = "15",
pages = "692--697",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Predictors of recurrence following catheter ablation of atrial fibrillation using an irrigated-tip ablation catheter

AU - Vasamreddy, Chandrasekhar R.

AU - Lickfett, Lars

AU - Jayam, Vinod K.

AU - Nasir, Khurram

AU - Bradley, David J.

AU - Eldadah, Zayd

AU - Dickfeld, Timm

AU - Berger, Ronald D

AU - Calkins, Hugh

PY - 2004/6

Y1 - 2004/6

N2 - Introduction: The aims of this study were to identify predictors of recurrence after catheter ablation of atrial fibrillation (AF) and to report the safety and efficacy of catheter ablation of AF using an irrigated-tip ablation catheter. Methods and Results: Seventy-five consecutive patients (51 men [68%]; age 54 ± 13 years) with symptomatic drug-refractory paroxysmal (42 patients), persistent (21 patients), or permanent (12 patients) AF underwent catheter ablation of AF using an irrigated-tip ablation catheter and a standard ablation strategy, which involved electrical isolation of all pulmonary veins (PVs) and creation of a cavotricuspid linear lesion. At 10.5 ± 7.5 months of follow-up following a single (n = 75) or redo ablation procedure (n = 11), 39 (52%) of the 75 patients were free of AF, 10 were improved (1.3%), and 26 had experienced no benefit from the ablation procedure (35%). Seventy-six percent of patients with paroxysmal AF were free from recurrent AF. The most significant complications were two episodes of pericardial tamponade, mitral valve injury in one patient, two strokes, and complete but asymptomatic PV stenosis in one patient. Cox proportional hazards multivariate regression analysis identified the presence of persistent AF, permanent AF, and age >50 years prior to the ablation are the only independent predictors of AF recurrence after the first PV isolation procedure. Conclusion: Catheter ablation of AF using a strategy involving isolation of all PVs and creation of a linear lesion in the cavotricuspid isthmus using cooled radiofrequency energy is associated with moderate efficacy and an important risk for complications. The best results of this procedure are achieved in the subset of patients who are younger than 50 years and have only paroxysmal AF.

AB - Introduction: The aims of this study were to identify predictors of recurrence after catheter ablation of atrial fibrillation (AF) and to report the safety and efficacy of catheter ablation of AF using an irrigated-tip ablation catheter. Methods and Results: Seventy-five consecutive patients (51 men [68%]; age 54 ± 13 years) with symptomatic drug-refractory paroxysmal (42 patients), persistent (21 patients), or permanent (12 patients) AF underwent catheter ablation of AF using an irrigated-tip ablation catheter and a standard ablation strategy, which involved electrical isolation of all pulmonary veins (PVs) and creation of a cavotricuspid linear lesion. At 10.5 ± 7.5 months of follow-up following a single (n = 75) or redo ablation procedure (n = 11), 39 (52%) of the 75 patients were free of AF, 10 were improved (1.3%), and 26 had experienced no benefit from the ablation procedure (35%). Seventy-six percent of patients with paroxysmal AF were free from recurrent AF. The most significant complications were two episodes of pericardial tamponade, mitral valve injury in one patient, two strokes, and complete but asymptomatic PV stenosis in one patient. Cox proportional hazards multivariate regression analysis identified the presence of persistent AF, permanent AF, and age >50 years prior to the ablation are the only independent predictors of AF recurrence after the first PV isolation procedure. Conclusion: Catheter ablation of AF using a strategy involving isolation of all PVs and creation of a linear lesion in the cavotricuspid isthmus using cooled radiofrequency energy is associated with moderate efficacy and an important risk for complications. The best results of this procedure are achieved in the subset of patients who are younger than 50 years and have only paroxysmal AF.

KW - Atrial fibrillation

KW - Atrium

KW - Irrigated-tip catheter ablation

KW - Pulmonary vein

UR - http://www.scopus.com/inward/record.url?scp=2942534487&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2942534487&partnerID=8YFLogxK

U2 - 10.1046/j.1540-8167.2004.03538.x

DO - 10.1046/j.1540-8167.2004.03538.x

M3 - Article

C2 - 15175066

AN - SCOPUS:2942534487

VL - 15

SP - 692

EP - 697

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 6

ER -