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

doi:10.1016/j.hrthm.2012.10.044

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 journal › Article

46 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	347-353
Number of pages	7
Journal	Heart Rhythm
Volume	10
Issue number	3
DOIs	https://doi.org/10.1016/j.hrthm.2012.10.044
Publication status	Published - Mar 2013
Externally published	Yes

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Keywords

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

Efforts to enhance catheter stability improve atrial fibrillation ablation outcome. / Hutchinson, Mathew D.; Garcia, Fermin C.; Mandel, Jeff E.; Elkassabany, Nabil; Zado, Erica S.; Riley, Michael P.; Cooper, Joshua M.; Bala, Rupa; Frankel, David S.; Lin, David; Supple, Gregory E.; Dixit, Sanjay; Gerstenfeld, Edward P.; Callans, David J.; Marchlinski, Francis E.

In: Heart Rhythm, Vol. 10, No. 3, 03.2013, p. 347-353.

Research output: Contribution to journal › Article

Hutchinson, Mathew D. ; Garcia, Fermin C. ; Mandel, Jeff E. ; Elkassabany, Nabil ; Zado, Erica S. ; Riley, Michael P. ; Cooper, Joshua M. ; Bala, Rupa ; Frankel, David S. ; Lin, David ; Supple, Gregory E. ; Dixit, Sanjay ; Gerstenfeld, Edward P. ; Callans, David J. ; Marchlinski, Francis E. / Efforts to enhance catheter stability improve atrial fibrillation ablation outcome. In: Heart Rhythm. 2013 ; Vol. 10, No. 3. pp. 347-353.

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abstract = "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",

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AU - Hutchinson, Mathew D.

AU - Garcia, Fermin C.

AU - Mandel, Jeff E.

AU - Elkassabany, Nabil

AU - Zado, Erica S.

AU - Riley, Michael P.

AU - Cooper, Joshua M.

AU - Bala, Rupa

AU - Frankel, David S.

AU - Lin, David

AU - Supple, Gregory E.

AU - Dixit, Sanjay

AU - Gerstenfeld, Edward P.

AU - Callans, David J.

AU - Marchlinski, Francis E.

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Y1 - 2013/3

N2 - 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

AB - 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

KW - Atrial fibrillation

KW - Catheter ablation

KW - High-frequency jet ventilation

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10.1016/j.hrthm.2012.10.044