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Evaluation of the Achieve Mapping Catheter in cryoablation for atrial fibrillation: a prospective randomized trial.

Gang, Y; Gonna, H; Domenichini, G; Sampson, M; Aryan, N; Norman, M; Behr, ER; Zuberi, Z; Dhillon, P; Gallagher, MM (2016) Evaluation of the Achieve Mapping Catheter in cryoablation for atrial fibrillation: a prospective randomized trial. Journal of Interventional Cardiac Electrophysiology, 45 (2). pp. 179-187. ISSN 1572-8595 https://doi.org/10.1007/s10840-015-0092-3
SGUL Authors: Behr, Elijah Raphael Gallagher, Mark Michael

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Abstract

PURPOSE: The purpose of this study is to establish the role of Achieve Mapping Catheter in cryoablation for paroxysmal atrial fibrillation (PAF) in a randomized trial. METHODS: A total of 102 patients undergoing their first ablation for PAF were randomized at 2:1 to an Achieve- or Lasso-guided procedure. Study patients were systematically followed up for 12 months with Holter monitoring. Primary study endpoint was acute procedure success. Secondary endpoint was clinical outcomes assessed by AF free at 6 and 12 months after the procedure. RESULTS: Of 102 participants, 99 % of acute procedure success was achieved. Significantly shorter procedure duration with the Achieve-guided group than with the Lasso-guided group (118 ± 18 vs. 129 ± 21 min, p < 0.05) was observed as was the duration of fluoroscopy (17 ± 5 vs. 20 ± 7 min, p < 0.05) by subgroup analysis focused on procedures performed by experienced operators. In the whole study patients, procedure and fluoroscopic durations were similar in the Achieve- (n = 68) and Lasso-guided groups (n = 34). Transient phrenic nerve weakening was equally prevalent with the Achieve and Lasso. No association was found between clinical outcomes and the mapping catheter used. The use of second-generation cryoballoon (n = 68) reduced procedure time significantly compared to the first-generation balloon (n = 34); more patients were free of AF in the former than the latter group during follow-up. CONCLUSIONS: The use of the Achieve Mapping Catheter can reduce procedure and fluoroscopic durations compared with Lasso catheters in cryoablation for PAF after operators gained sufficient experience. The type of mapping catheter used does not affect procedure efficiency and safety by models of cryoballoon.

Item Type: Article
Additional Information: © Springer Science+Business Media New York 2015. The final publication is available at Springer via http://dx.doi.org/10.1007/s10840-015-0092-37
Keywords: AF ablation, Circular mapping catheter, Cryoablation, Cryoballoon, Randomized controlled trial, AF ablation, Randomized controlled trial, Cryoballoon, Circular mapping catheter, Cryoablation, Cardiovascular System & Hematology, 1102 Cardiovascular Medicine And Haematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cardiac (INCCCA)
Journal or Publication Title: Journal of Interventional Cardiac Electrophysiology
ISSN: 1572-8595
Language: eng
Dates:
DateEvent
1 March 2016Published
Publisher License: Publisher's own licence
PubMed ID: 26698158
Web of Science ID: WOS:000372574500008
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107768
Publisher's version: https://doi.org/10.1007/s10840-015-0092-3

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