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Keywords:

  • atrial fibrillation;
  • radiofrequency ablation;
  • pulmonary vein

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)