Title : Intermediate term outcome after electrogram guided segmental ostialpulmonary vein isolation usinga 8 mm tip catheter for paroxysmal atrial fibrillation
Introduction: There is no Indian data on the outcome following conventional Radiofrequency catheter ablation (RFA) for patients with paroxysmal Atrial fibrillation (PAF). Inspite of recent advancements in this field including sophisticated three dimensional (3D) based imaging and advanced ablation catheters with contact force technology, many Indian patients will not afford such an expensive therapeutic procedure. Here in this article we have summarized the immediate and long term outcome following RFA of Indian patients with PAF using Pulmonary vein (PV) electrogram based mapping and using 8 mm tip ablation catheter.
Methods: 42 consecutive patients who underwent RFA for symptomatic PAF not controlled with atleast one antiarrhythmic drugs were studied in a tertiary care institute from March 2015 to December 2018. PVI was performed solely by conventional electrophysiology procedure using 8 mm tip RF catheter and PV potential electrogram based mapping. 3D mapping was not used. Only PVI was performed. Substrate modification was not performed. Elimination of all ostial pulmonary vein potentials and complete entrance block into the pulmonary vein were considered indicative of complete electrical isolation. Follow-up visits were scheduled at 4 weeks, and 3, 6, months post procedure, and every 6 months thereafter.
Results:After the procedure 34 were arrhythmia free, 8 continued to have atrial fibrillation.
Conclusion: Conventional RFA using PV potential electrogram based mapping and ablation with 8 mm tip catheter is safe and effective for patients with PAF with satisfactory immediate and long term outcome and negligible complications and very cost effective in our setting with limited resources.