Atrial Fibrillation Clinical Trial
Official title:
Comparison of Externally Versus Internally Cooled Tip Catheter in Achieving Long-term Electrical Isolation of Pulmonary Veins in Paroxysmal Atrial Fibrillation
There is no study comparing safety/efficacy of externally vs internally cooled tip catheters
in patients undergoing ablation for paroxysmal atrial fibrillation (pAF).
The primary objective is to compare safety and efficacy of externally irrigated-tip catheter
versus internally irrigated-tip catheter in achieving long term electrical isolation (EI) of
pulmonary veins (PV) in paroxysmalatrial fibrillation (pAF).
Atrial fibrillation is the most common of all sustained cardiac arrhythmias, with the
prevalence increasing with age to up to 5 percent in persons more than 65 years of age, to
10 percent in persons more than 80 years of age and it is a major cause of stroke.
Since its introduction into clinical practice, catheter ablation (CA) aimed at cure of
atrial fibrillation (AF) has become increasingly prevalent. Different techniques have been
proposed and are currently under investigation in various electrophysiology (EP)
laboratories, with increasing knowledge of the pathophysiology of human AF and critical
assessment of clinical outcome after the curative procedure. The favorable results reported
in different studies have fueled enthusiasm for CA of AF, with the number of ablation
procedures increasing from 1994 to the present time. However, these technologies have varied
catheter designs, ranging from different forms of irrigation (external or internal
irrigation). The increase of the rate of success of the AF by ablation with the development
of new catheters has permitted a considerable reduction of the medical treatment and the
disappearance of grave complications. The procedure will be " standard " with isolation of
pulmonary veins and block through the cavo-tricuspid isthmus obtained.
Following completion of the procedure, patients will have anti vitamin K drug therapy for 3
months and antiarrhythmic drug for 1 month in case of early atrial arrhythmia recurrence.
Two-dimensional echocardiogram will be performed systematically prior to discharge. All 3
months, long-term follow-up consisted from the date of the ablation procedure with
consultation, stress test, holter-ECG (24 h) and echocardiography. At 3 months a repeat EP
procedure will be performed in patients with AF recurrence to assess whether or not lines
are still blocked. If not, RF will be delivered to block them again and cure AF.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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