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Background: For conventional ablation of paroxysmal atrial fibrillation (AF), an ablation catheter in conjunction with a circular mapping catheter (CMC) is typically used for pulmonary vein isolation (PVI).Objective: The purpose of this study was to evaluate an approach for PVI with a single contact-force (CF) ablation catheter in terms of procedural reliability, outcomes, and cost-effectiveness.Methods: One hundred consecutive patients with paroxysmal AF were included in the study. Fifty patients (study group) underwent a CF-guided single-catheter approach, whereby PVI was demonstrated when sequential pacing at 9 equidistant points within the lesion set (carina included) failed to capture the left atrium. For confirmation, PVI was verified with a CMC. In comparison, 50 patients (control group) underwent a conventional PVI ablation guided by a CMC.Results: Procedure time (101 ± 17 minutes vs 107 ± 15 minutes, P = .11), ablation time (24.2 ± 7.1 minutes vs 22.6 ± 8.8 minutes, P = .37), fluoroscopy time (5.6 ± 2.2 minutes vs 8.3 ± 3.4 minutes, P = .09), and applied CF (17.8 ± 2.6 g vs 18 ± 2.8 g, P = .72) did not reach statistical difference between the study and control groups. CF-guided single-catheter ablation achieved successful PVI in 98% of the study group and a 31% reduction in cost. At 1-year follow-up, sinus rhythm maintenance rate was similar in both groups (86% vs 84%, P = .78).Conclusion: In paroxysmal AF, a CF-guided single-catheter technique is an effective method for PVI, yielding substantial cost savings and clinical results similar to a conventional approach. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims We hypothesized that left atrial appendage peak flow velocity (LAV) assessed by echocardiography was able to accurately predict successful catheter ablation as well as favorable outcome in the setting of long-standing persistent atrial fibrillation (AF). Methods This prospective pilot study enrolled 40 patients with long-standing persistent AF (age 60±11 years, persistence of AF 4.2±2 years) who underwent first catheter ablation procedure, using a standardized sequential stepwise protocol. LAV was assessed prior to catheter ablation procedure besides classical factors (age, gender, left atrial area, AF cycle length, AF duration, and left ventricular ejection fraction), and were tested using logistic regression for (i) restoration of sinus rhythm during catheter ablation as well as (ii) absence of recurrence during a one-year follow-up. Results Eighteen patients (45%) experienced AF termination during the procedure, and 18 patients (45%) did not develop any recurrence during the first 12-months. Multivariate analysis demonstrated that high LAV (>0.3 m. s-1) was the only independent predictor of AF termination (OR=5.91, 95%CI: 1.06-32.88, p=0.04) and absence of recurrence at one year (OR=4.33, 95%CI: 1.05-17.81, p=0.04). [ABSTRACT FROM AUTHOR]