Persistent Atrial Fibrillation Ablation using the Tip-Versatile Ablation Catheter

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Mechanisms of persistent atrial fibrillation (PsAF) are not fully understood.
• Optimal ablative strategies for PsAF are debated due to complexity and time.
• Novel catheter ablation techniques are needed for PsAF management.

Purpose of the Study:

• To assess the efficacy of the Tip-Versatile Ablation Catheter (T-VAC) technique.
• To evaluate a novel, rapidly delivered empirical technique for PsAF ablation.
• To determine long-term outcomes of T-VAC in PsAF patients.

Main Methods:

• Prospective data collection from 40 patients (44 procedures) undergoing PsAF ablation with T-VAC.
• Primary endpoint: freedom from arrhythmia at >2-year follow-up.
• Secondary endpoints: time to recurrence, AF freedom on/off antiarrhythmic drugs (AAD), procedure/fluoroscopy time, complications.

Main Results:

• At 33 months mean follow-up, 45% de novo patients achieved freedom from arrhythmia recurrence.
• Overall, 60% of de novo patients maintained sustained normal sinus rhythm long-term.
• An additional 15% reported occasional AF paroxysms; procedure time averaged 192 minutes.

Conclusions:

• The T-VAC technique can achieve a 60% arrhythmia-free survival rate off AAD in selected PsAF patients.
• This novel technique offers a potentially effective approach to managing persistent atrial fibrillation.
• Long-term follow-up demonstrates sustained efficacy for the T-VAC method.