Efforts to enhance catheter stability improve atrial fibrillation ablation outcome

Mathew D. Hutchinson, Fermin C. Garcia, Jeff E. Mandel, Nabil Elkassabany, Erica S. Zado, Michael P. Riley, Joshua M. Cooper, Rupa Bala, David S. Frankel, David Lin, Gregory E. Supple, Sanjay Dixit, Edward P. Gerstenfeld, David J. Callans, Francis E. Marchlinski

Research output: Contribution to journalArticle

46 Scopus citations


Background: Contemporary techniques to enhance anatomical detail and catheter contact during atrial fibrillation (AF) ablation include (1) the integration of preacquired tomographic reconstructions with electroanatomical mapping (3-dimensional image integration [I-EAM]), (2) the use of steerable introducers (SIs), and (3) high-frequency jet ventilation (HFJV). Objective: To prove that using these stabilizing techniques during AF ablation improves 1-year procedural outcome. Methods: We studied 300 patients undergoing AF ablation at our institution. Patients were divided into 3 equal treatment groups (100 patients each) on the basis of the tools utilized: (1) group 1: AF ablation performed without I-EAM, SI, or HFJV; (2) group 2: AF ablation performed using I-EAM and SI, but without HFJV; and (3) group 3: AF ablation performed with I-EAM, SI, and HFJV. The primary outcome was freedom from AF 1 year after a single ablation procedure. The burden of both acute and chronic pulmonary vein reconnection was also assessed. Results: Patients from groups 2 and 3 had significantly more nonparoxysmal AF (17% vs 30% vs 39%; P =.002), larger left atria (4.2±0.8 cm vs 4.4±0.7 cm vs 4.5±0.8 cm; P2 vs 29.1±4.8 kg/m2 vs 31.2±5.4 kg/m2; P

Original languageEnglish (US)
Pages (from-to)347-353
Number of pages7
JournalHeart Rhythm
Issue number3
Publication statusPublished - Mar 2013
Externally publishedYes



  • Atrial fibrillation
  • Catheter ablation
  • High-frequency jet ventilation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Hutchinson, M. D., Garcia, F. C., Mandel, J. E., Elkassabany, N., Zado, E. S., Riley, M. P., ... Marchlinski, F. E. (2013). Efforts to enhance catheter stability improve atrial fibrillation ablation outcome. Heart Rhythm, 10(3), 347-353. https://doi.org/10.1016/j.hrthm.2012.10.044