Feasibility of Pulmonary Vein Ostia Radiofrequency Ablation in Patients with Atrial Fibrillation: A Multicenter Study (CACAF Pilot Study)

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Abstract
STABILE, G., et al.: Feasibility of Pulmonary Vein Ostia Radiofrequency Ablation in Patients with Atrial Fibrillation: A Multicenter Study (CACAF Pilot Study) Radiofrequency (RF) catheter ablation has been proposed as a treatment of atrial fibrillation (AF). Several approaches have been reported and success rates have been dependent on procedural volume and operator's experience. This is the first report of a multicenter study of RF ablation of AF. We treated 44 men and 25 women with paroxysmal (n = 40) or persistent (n = 29) , drug refractory AF. Circular pulmonary vein (PV) ostial lesions were deployed transseptally, during sinus rhythm(n = 42)or AF(n = 26), under three‐dimensional electroanatomic guidance. Cavo‐tricuspid isthmus ablation was performed in 27 (40%) patients. The mean procedure time was215 ± 76minutes (93–530), mean fluoroscopic exposure32 ± 14minutes (12–79), and mean number of RF pulses per patient56 ± 29(18–166). The mean numbers of separate PV ostia mapped and isolated per patient were3.9 ± 0.5, and3.8 ± 0.7, respectively. Major complications were observed in 3 (4%) patients, including pericardial effusion, transient ischemic attack, and tamponade. At 1‐month follow‐up, 21 of 68 (31%) patients had had AF recurrences, of whom 8 required electrical cardioversion. After the first month, over a mean period of9 ± 3(5–14) months, 57 (84%) patients remained free of atrial arrhythmias. RF ablation of AF by circumferential PV ostial ablation is feasible with a high short‐term success rate. While the procedure and fluoroscopic exposure duration were short, the incidence of major cardiac complications was not negligible. (PACE 2003; 26[Pt. II]:284–287)