Effects of the visualized steerable sheath applied to catheter ablation of paroxysmal atrial fibrillation

J Interv Card Electrophysiol. 2022 Aug;64(2):511-518. doi: 10.1007/s10840-021-01096-7. Epub 2021 Nov 30.

Abstract

Purpose: A new type of visualized steerable sheath (Vizigo sheath; Biosense Webster Inc., Irvine, CA, USA) has been employed in clinical treatment. This study aimed to compare the effectiveness and safety of the Vizigo sheath to a fixed sheath (Swartz sheath; St. Jude Inc., St. Paul, MN, USA) for catheter ablation of paroxysmal atrial fibrillation (PAF).

Methods: We analyzed the procedural time, fluoroscopy time, contact force (CF), and initial pulmonary vein isolation (PVI) rate. After 6 months of follow-up, the success rate of ablation between the two groups was compared.

Results: Compared to the Swartz sheath, using the Vizigo sheath can significantly reduce the total procedural time and fluoroscopy time and increase the overall average CF, especially in the anterior left pulmonary vein (LPV), superior LPV, posterior right pulmonary vein (RPV), and superior RPV. The proportion of CF within a reasonable range in the Vizigo group was significantly higher than that in the Swartz group, especially in the anterior LPV, posterior RPV, and superior RPV. Besides, the left, right, and bilateral initial PVI rates in the Vizigo group were significantly higher.

Conclusions: The visualized steerable sheath for PAF catheter ablation not only reduced radiation exposure but also significantly improved CF and initial PVI rate, all of which indicated an increased rate of successful ablation.

Keywords: Catheter ablation; Contact force; Paroxysmal atrial fibrillation; Pulmonary vein isolation; Steerable sheath.

MeSH terms

  • Atrial Fibrillation* / diagnostic imaging
  • Atrial Fibrillation* / surgery
  • Catheter Ablation*
  • Fluoroscopy
  • Humans
  • Pulmonary Veins* / surgery
  • Treatment Outcome