A comparison of open irrigated and non-irrigated tip catheter ablation for pulmonary vein isolation

The relative efficacy and safety of open irrigated tip catheters compared with conventional non-irrigated catheters for pulmonary vein isolation (PVI) is unknown.

Forty-eight patients undergoing PVI using an open irrigated tip ablation catheter (Group 1) were compared with a group of 31 historical controls (Group 2). The control group underwent similar procedures using a standard, 4 mm tip, temperature controlled ablation catheter. Electrical mapping with a circular catheter was used to guide segmental radiofrequency ablation at the vein ostia.

At follow-up (3.5+/-3.5 months) after a single procedure 35/48 (73%) patients in Group 1 and 14/31 (45%) in Group 2 were in sinus rhythm (p=0.03). Antiarrhythmic drug use was lower among those in Group 1 maintained in sinus rhythm (9/35 (26%) vs 8/14 (57%), p=0.002). Recurrent atrial fibrillation was more common in Group 2 (28/31 (90%) vs 28/48 (58%) p=0.004). Serious complications were uncommon in both groups.

Compared with an historical control group, pulmonary vein isolation using open irrigated tip catheters was superior to ablation with conventional 4 mm tip catheters. Patients undergoing ablation with an irrigated tip catheter were less likely to experience symptomatic recurrences of atrial fibrillation or require further therapy for post-procedural arrhythmias.