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 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)347-353
Number of pages7
JournalHeart Rhythm
Volume10
Issue number3
DOIs
StatePublished - Mar 2013
Externally publishedYes

Fingerprint

Atrial Fibrillation
Catheters
High-Frequency Jet Ventilation
Pulmonary Veins
Heart Atria

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 journalArticle

Hutchinson, MD, Garcia, FC, Mandel, JE, Elkassabany, N, Zado, ES, Riley, MP, Cooper, JM, Bala, R, Frankel, DS, Lin, D, Supple, GE, Dixit, S, Gerstenfeld, EP, Callans, DJ & Marchlinski, FE 2013, 'Efforts to enhance catheter stability improve atrial fibrillation ablation outcome', Heart Rhythm, vol. 10, no. 3, pp. 347-353. https://doi.org/10.1016/j.hrthm.2012.10.044
Hutchinson MD, Garcia FC, Mandel JE, Elkassabany N, Zado ES, Riley MP et al. Efforts to enhance catheter stability improve atrial fibrillation ablation outcome. Heart Rhythm. 2013 Mar;10(3):347-353. https://doi.org/10.1016/j.hrthm.2012.10.044
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.
@article{8d903279fdbe4d9f8effae1776e94bfc,
title = "Efforts to enhance catheter stability improve atrial fibrillation ablation outcome",
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",
keywords = "Atrial fibrillation, Catheter ablation, High-frequency jet ventilation",
author = "Hutchinson, {Mathew D.} and Garcia, {Fermin C.} and Mandel, {Jeff E.} and Nabil Elkassabany and Zado, {Erica S.} and Riley, {Michael P.} and Cooper, {Joshua M.} and Rupa Bala and Frankel, {David S.} and David Lin and Supple, {Gregory E.} and Sanjay Dixit and Gerstenfeld, {Edward P.} and Callans, {David J.} and Marchlinski, {Francis E.}",
year = "2013",
month = "3",
doi = "10.1016/j.hrthm.2012.10.044",
language = "English (US)",
volume = "10",
pages = "347--353",
journal = "Heart Rhythm",
issn = "1547-5271",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - Efforts to enhance catheter stability improve atrial fibrillation ablation outcome

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.

PY - 2013/3

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

UR - http://www.scopus.com/inward/record.url?scp=84875298175&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875298175&partnerID=8YFLogxK

U2 - 10.1016/j.hrthm.2012.10.044

DO - 10.1016/j.hrthm.2012.10.044

M3 - Article

C2 - 23128019

AN - SCOPUS:84875298175

VL - 10

SP - 347

EP - 353

JO - Heart Rhythm

JF - Heart Rhythm

SN - 1547-5271

IS - 3

ER -