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Comparison of the change in the dimension of the pulmonary vein ostia immediately after pulmonary vein isolation for atrial fibrillation-open irrigated-tip catheters versus non-irrigated conventional 4 mm-tip catheters

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Abstract

Introduction

A difference in the lesion formation between open irrigated-tip (OITC) and non-irrigated 4-mm-tip catheters (NITC) may result in a difference in the dimension of the pulmonary vein (PV) ostia after PV isolation of atrial fibrillation (AF). This study evaluated the difference using intracardiac echocardiography (ICE) before and immediately after an extensive encircling PV isolation (EPVI) with an OITC and with an NITC.

Methods and results

We studied 100 consecutive patients (OITC group, 54; NITC group, 46) who received EPVI. Changes in the vessel, lumen, and wall thickness areas of the PVs were evaluated at the PV ostia by ICE. There were no significant differences in the baseline characteristics and acute success rate of the EPVI between the OITC and NITC groups. The energy delivered to achieve EPVI was higher in the OITC group than that in the NITC group (34,967 ± 13,222 J vs. 28,300 ± 10,614 J; p = 0.01). After the ablation, the reduction in the vessel and lumen cross-sectional areas was significantly smaller in the OITC group than that in the NITC group (−9.05 ± 28.4 % vs. −21.2 ± 28.8 %, p < 0.001; −8.76 % vs. −17.7 ± 26.9 %, p = 0.003). The wall thickness area slightly decreased in the OITC group, but increased in the NITC group (−2.96 ± 38.4 % vs. 10.5 ± 76.6 %, p = 0.591). During a median follow-up of 234 days, there was no significant difference in the AF recurrence after the initial ablation procedure between the two groups.

Conclusion

Greater PV ostial narrowing occurred with the NITC than OITC immediately after the EPVI. PV ostial wall edema was noted with only the NITC. These findings suggested that an OITC might reduce any acute PV narrowing and wall edema as compared with an NITC.

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Acknowledgments

There was no financial support for this study.

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Authors and Affiliations

  1. Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Takashi Yamamoto, Yasuya Inden, Masayuki Shimano, Rei Shibata & Toyoaki Murohara

  2. Division of Cardiovascular Disease, University of Alabama at Birmingham, FOT 930E, 510 20th Street South, 1530 3rd AVE S, Birmingham, AL, 35294-0019, USA

    Takumi Yamada

  3. Department of Cardiology, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Yukihiko Yoshida, Hirohiko Suzuki, Monami Ando & Haruo Hirayama

  4. Department of Cardiology, Social Insurance Chukyo Hospital, Nagoya, Japan

    Naoya Tsuboi

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  1. Takashi Yamamoto
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  2. Takumi Yamada
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  3. Yukihiko Yoshida
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  4. Yasuya Inden
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Correspondence to Takumi Yamada.

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Yamamoto, T., Yamada, T., Yoshida, Y. et al. Comparison of the change in the dimension of the pulmonary vein ostia immediately after pulmonary vein isolation for atrial fibrillation-open irrigated-tip catheters versus non-irrigated conventional 4 mm-tip catheters. J Interv Card Electrophysiol 41, 83–90 (2014). https://doi.org/10.1007/s10840-014-9919-6

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  • DOI: https://doi.org/10.1007/s10840-014-9919-6

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