Circular mapping and ablation of the pulmonary vein for treatment of atrial fibrillation: impact of different catheter technologies. Marrouche, N., Dresing, T., Cole, C., Bash, D., Saad, E., Balaban, K., Pavia, S., Schweikert, R., Saliba, W., Abdul-Karim, A., Pisano, E., Fanelli, R., Tchou, P., & Natale, A. j-ACC, 40(3):464–474, 2002.
bibtex   
@Article{RSM:Mar2002,
  author =       "N.F. Marrouche and T. Dresing and C. Cole and D. Bash
                 and E. Saad and K. Balaban and S.V. Pavia and R.
                 Schweikert and W. Saliba and A. Abdul-Karim and E.
                 Pisano and R. Fanelli and P. Tchou and A. Natale",
  title =        "Circular mapping and ablation of the pulmonary vein
                 for treatment of atrial fibrillation: impact of
                 different catheter technologies.",
  journal =      j-ACC,
  year =         "2002",
  volume =       "40",
  number =       "3",
  pages =        "464--474",
  robnote =      "afib OBJECTIVES: We conducted this study to compare the
                 efficacy and safety of different catheter ablation
                 technologies and of distal versus ostial pulmonary
                 veins (PV) isolation using the circular mapping
                 technique. BACKGROUND: Electrical isolation of the PVs
                 in patients with atrial fibrillation (AF) remains a
                 technical challenge. METHODS: Two hundred eleven
                 patients (163 men; mean age 53 +/- 11 years) with
                 symptomatic AF were included in this study. In the
                 first 21 patients (group 1), distal isolation (> or = 5
                 mm from the ostium) was achieved targeting veins
                 triggering AF. In the remaining 190 patients (group 2),
                 ostial isolation of all PVs was performed using 4-mm
                 tip (47 patients), 8-mm tip (21 patients), or
                 cooled-tip (122 patients) ablation catheters. RESULTS:
                 Distal isolation was able to eliminate premature atrial
                 contractions (PACs) and AF in six of 21 patients (29\%)
                 and 10 of 34 PVs. After a mean follow-up time of 6 +/-
                 4 months, no patients treated with the 8-mm tip
                 catheter experienced recurrence of AF, whereas 21\% (10
                 of 47 patients) and 15\% (18 of 122 patients) of the
                 patients ablated with the 4-mm tip and the cooled-tip
                 ablation catheters experienced recurrence of AF after a
                 mean follow-up of 10 +/- 3 and 4 +/- 2 months,
                 respectively. Significant complications including
                 stroke, tamponade, and severe stenosis occurred in
                 3.5\% (8/211) of patients. CONCLUSIONS: Catheter
                 technologies designed to achieve better lesion size
                 appeared to have a positive impact on procedure time,
                 fluoroscopy time, number of lesions, and overall
                 efficacy. Although distal isolation can be achieved
                 with fewer lesions, ostial isolation is required in the
                 majority of patients to eliminate arrhythmogenic PACs
                 and AF.",
  bibdate =      "Sat Aug 11 12:17:51 2007",
}

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