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Europace 2004 6(4):330-335; doi:10.1016/j.eupc.2004.03.001
© 2004 by European Society of Cardiology
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A comparison of open irrigated and non-irrigated tip catheter ablation for pulmonary vein isolation

Stuart P. Thomas*, Gunjan Aggarwal, Anita C. Boyd, Yuanzhe Jin and David L. Ross

Department of Cardiology, Westmead Hospital and Westmead Private Hospital Westmead, NSW 2145, Australia

AIMS: The relative efficacy and safety of open irrigated tip catheters compared with conventional non-irrigated catheters for pulmonary vein isolation (PVI) is unknown.

METHODS: Forty-eight patients undergoing PVI using an open irrigated tip ablation catheter (Group 1) were compared with a group of 31 historical controls (Group 2). The control group underwent similar procedures using a standard, 4 mm tip, temperature controlled ablation catheter. Electrical mapping with a circular catheter was used to guide segmental radiofrequency ablation at the vein ostia.

RESULTS: At follow-up (3.5±3.5 months) after a single procedure 35/48 (73%) patients in Group 1 and 14/31 (45%) in Group 2 were in sinus rhythm (p=0.03). Antiarrhythmic drug use was lower among those in Group 1 maintained in sinus rhythm (9/35 (26%) vs 8/14 (57%), p=0.002). Recurrent atrial fibrillation was more common in Group 2 (28/31 (90%) vs 28/48 (58%) p=0.004). Serious complications were uncommon in both groups.

CONCLUSIONS: Compared with an historical control group, pulmonary vein isolation using open irrigated tip catheters was superior to ablation with conventional 4 mm tip catheters. Patients undergoing ablation with an irrigated tip catheter were less likely to experience symptomatic recurrences of atrial fibrillation or require further therapy for post-procedural arrhythmias.

Key Words: atrial fibrillation, radiofrequency ablation, pulmonary vein isolation, pulmonary veins, irrigated tip, cooled tip

*Corresponding author. Tel.: +61-2-9845-6795; fax: +61-2-9845-8323. E-mail address: stuartpt{at}yahoo.com (S.P. Thomas).


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