The Feasibility and Efficacy of Ablation of Paroxysmal Atrial Fibrillation Using Different Technologies

This analysis assesses the efficacy of ablation of paroxysmal atrial fibrillation (PAF). Methods: We studied 150 patients (pts) (86 males and 64 females) having a mean age of 51.3 yrs. (54 > 50, 96 below 50 yrs.), who suffered from symptomatic drug refractory paroxysmal AF. Cardiac MSCT (Multi Slice Computed Tomography) image integration to the 3D electroanatomic LA map was used in 106 pts (70.6%, however all of them underwent intracardiac echo guided imaging during the ablation procedure. 40 pts underwent manual radio frequency (RF) ablation using CARTO, 40 pts underwent ablation using NavX system, 70 pts underwent robotic ablation using Sansui system. Results: 34 patients (22.6%) developed early recurrence of AF after an initial blanking period of 3 months. The incidence of recurrence of AF in males was 13% (11/86), 14% in females (9/64), P= NS. ECG during follow up: Atrial Tachycardia 4, PAF 2, A. flutter 2. Complications: air embolism zero, cardiac tamponade zero, trivial pericardial effusion 1, groin hematoma 5%, pulmonary vein stenosis > 50% zero. There was no difference between males and females in success of ablation or complications. Those below age 50 and above 50 were not different in incidence of maintenance of SR or complications. In all, the mean age was 53.6 years in successful group and 58 years in failure group, with no significant differences between both groups. Conclusions: The success rate for the robotic group was 92.4%. The manually treated group (Carto and NavX) has a success rate of 88.5%.