Data on procedural handling and complications of pulmonary vein isolation using the pulmonary vein ablation catheter GOLD®

Europace. 2016 May;18(5):696-701. doi: 10.1093/europace/euv355. Epub 2015 Dec 23.

Abstract

Aims: The second-generation multi-electrode-phased radiofrequency pulmonary vein ablation catheter (PVAC GOLD(®)) was redesigned with the intent to improve its safety and efficacy.

Methods and results: Using a prospectively designed single-centre database, we retrospectively analysed 128 consecutive patients (102 paroxysmal and 43 female) who underwent their first pulmonary vein isolation with the PVAC GOLD(®). The analysis focused on procedural data as well as in-hospital complications. Baseline characteristics of the patient collective were as follows: mean age 57.9 years, mean CHA2DS2-VASC was 1.73 ± 1.30; structural heart disease was present in seven patients. The PVAC GOLD(®) exhibited procedure durations of 123.1 min ± 27.9, duration of energy delivery was 18.3 min ± 11.4, and fluoroscopy duration was 16.0 min ± 7.7. The redesigned catheter shows major complication [major bleeding, transitory ischaemic attack (TIA), and pericardial tamponade] rates of 2.3% (n = 3). The overall rate of adverse events was 5.4% (n = 7). Bleeding complications were observed in three patients (2.3%), in particular there were two cases (1.6%) of minor bleeding and one case (0.8%) of major bleeding. Two patients suffered pericardial effusion, but there was no need for pericardiocentesis. Besides one TIA, there was no other thrombo-embolic event. Furthermore, one case of post-procedural fever was observed. No deaths, stroke, or haemorrhagic shock occurred. Of the 510 pulmonary veins, 508 could be reached with the PVAC GOLD(®) device using a non-steerable long sheath.

Conclusion: The PVAC GOLD(®) seems to have an acceptable safety profile. The handling is comparable with the previous generation PVAC(®).

Keywords: Atrial fibrillation; Pulmonary vein isolation; Safety; Second-generation multi-electrode-phased radiofrequency ablation.

MeSH terms

  • Aged
  • Antithrombins / therapeutic use
  • Atrial Fibrillation / therapy*
  • Catheter Ablation / adverse effects
  • Catheter Ablation / instrumentation*
  • Dabigatran / therapeutic use
  • Databases, Factual
  • Electrodes, Implanted / adverse effects
  • Equipment Design
  • Europe
  • Factor Xa Inhibitors / therapeutic use
  • Female
  • Hemorrhage / etiology
  • Humans
  • Ischemic Attack, Transient / etiology
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Pulmonary Veins / surgery*
  • Retrospective Studies
  • Rivaroxaban / therapeutic use
  • Treatment Outcome

Substances

  • Antithrombins
  • Factor Xa Inhibitors
  • Rivaroxaban
  • Dabigatran