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Updated: Jun 3, 2026
Direct Pressure Monitoring Accurately Predicts Pulmonary Vein Occlusion During Cryoballoon Ablation
Published on: February 26, 2013
Randomized study comparing duty-cycled bipolar and unipolar radiofrequency with point-by-point ablation in pulmonary
Alex Bittner1, Gerold Mönnig, Stephan Zellerhoff
1Department of Cardiology and Angiology, Division of Experimental and Clinical Electrophysiology, University Hospital of Münster, Münster, Germany.
Background:
Pulmonary vein (PV) electrical isolation is a therapeutic option in atrial fibrillation (AF). New technologies may reduce the complexity of the procedure.
Objective:
The aim of the present study was to compare immediate results and short-term efficacy of a new circular ablation catheter (PVAC) with a conventional point-by-point ablation.
Methods:
The prospective study enrolled 80 consecutive patients with paroxysmal AF or persistent AF, refractory to antiarrhythmic drugs, who were randomized to radiofrequency ablation using duty-cycled bipolar and unipolar radiofrequency by a decapolar circular catheter (PVAC group) or to point-by-point ablation supported by a 3-dimensional mapping system (3D group).
Results:
Forty patients per group were included. Mean age was 58 ± 10 years, 64% were male; 55% had paroxysmal AF, 45% had persistent AF. There were no significant differences between groups. Complete electrical isolation was reached in all but 1 PV, which was not isolated in the PVAC group because of phrenic nerve capture. Procedure and fluoroscopy times were lower in the PVAC group: 171 ± 40 minutes vs. 224 ± 27 minutes, P < .001; 26 ± 8 minutes vs. 35 ± 9 minutes, P < .001; respectively. There were no major complications. During a mean follow-up of 254 ± 99 days, 72% in the PVAC group and 68% in the 3D group were free of AF recurrences irrespective of the initial AF type (P = NS).
Conclusion:
PVAC represents a safe alternative for PV isolation. It reduces both procedure and fluoroscopy time. The short- and middle-term efficacy is comparable to a conventional point-by-point antral ablation technique.
