Comparison of Cool Tip Versus 8-mm Tip Catheter in Achieving Electrical Isolation of Pulmonary Veins for Long-Term Control of Atrial Fibrillation: A Prospective Randomized Pilot Study

Authors: DIXIT, SANJAY¹; GERSTENFELD, EDWARD P.¹; CALLANS, DAVID J.¹; COOPER, JOSHUA M.¹; LIN, DAVID¹; RUSSO, ANDREA M.¹; VERDINO, RALPH J.¹; PATEL, VICKAS V.¹; KIMMEL, STEPHEN E.¹; RATCLIFFE, SARAH J.¹; HSIA, HENRY H.¹; NAYAK, HEMAL M.¹; ZADO, ERICA¹; REN, JIAN-FANG¹; MARCHLINSKI, FRANCIS E.¹

Source: Journal of Cardiovascular Electrophysiology, Volume 17, Number 10, October 2006 , pp. 1074-1079(6)

Publisher: Blackwell Publishing

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By this author: DIXIT, SANJAY ; GERSTENFELD, EDWARD P. ; CALLANS, DAVID J. ; COOPER, JOSHUA M. ; LIN, DAVID ; RUSSO, ANDREA M. ; VERDINO, RALPH J. ; PATEL, VICKAS V. ; KIMMEL, STEPHEN E. ; RATCLIFFE, SARAH J. ; HSIA, HENRY H. ; NAYAK, HEMAL M. ; ZADO, ERICA ; REN, JIAN-FANG ; MARCHLINSKI, FRANCIS E.

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Abstract:

Cool Tip and 8-mm Tip for Pulmonary Vein Isolation.

Objective: To compare safety and efficacy of 8-mm versus cooled tip catheter in achieving electrical isolation (EI) of pulmonary veins (PV) for long-term control of atrial fibrillation (AF).

Background: There is paucity of studies comparing safety/efficacy of 8-mm and cooled tip catheters in patients undergoing AF ablation.

Methods and Results: This was a randomized and patient-blinded study. Subjects were followed by clinic visits (at 6 weeks and 6 months) and transtelephonic monitoring (3-week duration) done around each visit. Primary endpoints were: (1) long-term AF control (complete freedom and/or >90% reduction in AF burden on or off antiarrhythmic drugs at 6 months after a single ablation), and (2) occurrence of serious adverse events (cardiac tamponade, stroke, LA-esophageal fistula, and/or death). Eighty-two patients (age 56 ± 9 years, 60 males, paroxysmal AF = 59) were randomized (42 patients to 8-mm tip and 40 patients to cooled tip). EI of PVs was achieved in shorter time by the 8-mm tip as compared with cooled tip catheter (40 ± 23 minutes vs 50 ± 30 minutes; P < 0.05) but long-term AF control was not different between the two (32 patients [78%] vs 28 patients [70%], respectively; P = NS). One serious adverse event occurred in each group (LA-esophageal fistula and stroke, respectively) and no significant PV stenosis was observed in either.

Conclusion: EI of PVs using either 8-mm or cooled tip catheter results in long-term AF control in the majority after a single ablation procedure, with comparable efficacy and safety.

(J Cardiovasc Electrophysiol, Vol. 17, pp. 1074-1079, October 2006)

Keywords: atrial fibrillation; pulmonary vein; catheter ablation

Document Type: Research article

DOI: 10.1111/j.1540-8167.2006.00558.x

Affiliations: 1: Cardiovascular Division, Hospital of The University of Pennsylvania and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA