Learning curve in circular multipolar phased radiofrequency ablation of atrial fibrillation

AbstractBackground: Although atrial fibrillation (AF) ablation is considered a technically challengingprocedure, studies on the learning curve of different pulmonary vein isolation (PVI)techniques are limited. We investigated the time-dependent changes in procedural parameters,complication rates, and in the 1-year clinical outcome during our initial experience with circularmultipolar phased radiofrequency (RF) ablation.Methods and results: The first 132 consecutive patients (40 female; age: 56.6 ± 10.4 years)who underwent PVI with phased RF ablation for paroxysmal or persistent AF at our centerwere included in the study. Procedural parameters and atrial arrhythmia-free survival werecompared in the first, second and third group of 44 successive patients. All pulmonary veinswere successfully isolated in 44 (100%), 41 (93.8%) and 42 (95.5%) patients in Tierce 1,2 and 3, respectively (p = 0.233). The number of RF applications (per vein) required for isolationand fluoroscopy times demonstrated a significant decrease with experience, and a trendtowards lower procedure times in Tierces 2 and 3 was also observed. Atrial arrhythmia-freesurvival rates at 12 months postablation were 68.18%, 75%, and 70.75% in Tierce 1, Tierce 2and Tierce 3, respectively (p = 0.772). Pericardial tamponade requiring percutaneous subxiphoiddrainage occurred in 1 patient (Tierce 3) as the only significant procedural complication.Conclusions: A learning curve effect was demonstrated in fluoroscopy times and in thenumber of RF applications but not in the acute success and in the long-term arrhythmia-freesurvival with circular multipolar RF ablations. (Cardiol J 2015; 22, 3: 260–266

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újratöltve - BIBFORM01550