COMPARATIVE STUDY
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Electroanatomical systems to guided circumferential pulmonary veins ablation for atrial fibrillation: initial experience from comparison between the Ensite/NavX and CARTO system

Xu Liu, Xin-hua Wang, Jia-ning Gu, Li Zhou, Jian-hua Qiu
Chinese Medical Journal 2005 July 20, 118 (14): 1156-60
16117859

BACKGROUND: The circumferential pulmonary vein ablation (CPVA) has been proved effective for atrial fibrillation (AF) treatment and is becoming more widely accepted and practiced. This study aims to evaluate the characteristics of the CARTO and the Ensite/NavX system and draw a comparison between them on the aspects of procedural parameters and clinical effectiveness.

METHODS: Seventy-five cases with paroxysmal or chronic symptomatic AF were randomly assigned to CPVA procedure guided by the Ensite/NavX system (group I, n = 40) and by the CARTO system (group II, n = 35). After successful transseptal procedure, the geometry of left atrium was created under the guidance of the two systems. Radiofrequency energy was applied to circumferentially ablate tissues out of pulmonary veins' (PVs') ostia. In cases with chronic AF, linear ablation was applied to modify the substrate of left atrium (LA). The endpoint of the procedure was complete PVs isolation.

RESULTS: Seventy-five cases underwent the procedure successfully. The total procedure and fluoroscopic durations in group II were significantly shorter than in group I [(150 +/- 23) min and (18 +/- 17) min versus (170 +/- 34) min and (25 +/- 16) min, P = 0.03 and 0.04, respectively]. There was no significant difference in the fluoroscopic and procedure durations for geometry creation between group I and group II [(8 +/- 4) min and (16 +/- 11) min versus (5 +/- 4) min and (14 +/- 8) min, respectively]. The fluoroscopic durations for CPVA were (15 +/- 5) min in group I versus (10 +/- 6) min in group II (P = 0.05), and the CPVA procedural durations were significantly shorter in group II than in group I [(18 +/- 11) min versus (25 +/- 10) min, P = 0.04]. AF was terminated by radio frequency delivery in 14 cases (35%) in group I versus 5 cases (14%) in group II (P = 0.035). After CPVA complete PV isolation was attained in 26 cases (65%) in group I versus 11 cases (31%) in group II (P = 0.004). During a mean follow-up of 7 months, 32 (80%) cases in group I and 24 (69%) cases in group II were arrhythmia-free (P = 0.06). One case developed pericardium effusion and another one case was found to have intestinal artery thrombosis in group II. One case had moderate hemothorax in group I. All the complications were cured by proper treatment. No PV stenosis was observed.

CONCLUSIONS: The CPVA procedure for atrial fibrillation is effective and safe. Although there is difference between the CARTO and the Ensite/NavX system, the CPVA procedure guided by either of them yields similar clinical results.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
16117859
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"