Risks and benefits of an open irrigation tip catheter in intensive radiofrequency catheter ablation in patients with non-paroxysmal atrial fibrillation

Eui Seock Hwang, Hui Nam Pak, Sang Weon Park, Jong Sung Park, Boyoung Joung, Donghoon Choi, Moon Hyoung Lee, Young Hoon Kim

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Although open irrigation tip catheters (OITC) are effective in producing transmural radiofrequency (RF) lesions, they have the potential for fluid overload or excessive tissue damage. Methods and Results: The 203 patients with non-paroxysmal atrial fibrillation (NPAF; 85.2% males, 55.2±10.6 years old) who underwent RF catheter ablation (RFCA) were analyzed retrospectively. Clinical outcomes and complications were compared between RFCA using OITC (n=92) and that using conventional catheters (CONC; n=111). Both the total procedure time (P<0.01) and fluoroscopic time (P<0.001) were shorter in the OITC group than in the CONC group. Total fluid loading during RFCA with OITC was 3.2±0.9L, and the average body weight increase was 1.8±1.2 kg. Symptomatic pulmonary edema and/or pleural effusion occurred in 3.3% of patients who had a bigger left atrium (P=0.005), longer duration of ablation procedure (P=0.002), higher post-RFCA serum pro-ANP level (P<0.001), and longer hospitalization (P<0.01). Conclusions: RFCA for NPAF using OITC results in a shorter procedure time compared with CONC. However, patients with a large left atrium and a large amount of fluid (>4L) infused via the OITC need to be carefully monitored to prevent pulmonary edema or pleural effusion because of fluid overload.

Original languageEnglish
Pages (from-to)644-649
Number of pages6
JournalCirculation Journal
Volume74
Issue number4
DOIs
Publication statusPublished - 2010 Apr 16

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Catheter Ablation
Atrial Fibrillation
Catheters
Pulmonary Edema
Pleural Effusion

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Irrigation tip catheter

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Risks and benefits of an open irrigation tip catheter in intensive radiofrequency catheter ablation in patients with non-paroxysmal atrial fibrillation. / Hwang, Eui Seock; Pak, Hui Nam; Park, Sang Weon; Park, Jong Sung; Joung, Boyoung; Choi, Donghoon; Lee, Moon Hyoung; Kim, Young Hoon.

In: Circulation Journal, Vol. 74, No. 4, 16.04.2010, p. 644-649.

Research output: Contribution to journalArticle

Hwang, Eui Seock ; Pak, Hui Nam ; Park, Sang Weon ; Park, Jong Sung ; Joung, Boyoung ; Choi, Donghoon ; Lee, Moon Hyoung ; Kim, Young Hoon. / Risks and benefits of an open irrigation tip catheter in intensive radiofrequency catheter ablation in patients with non-paroxysmal atrial fibrillation. In: Circulation Journal. 2010 ; Vol. 74, No. 4. pp. 644-649.
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AU - Park, Jong Sung

AU - Joung, Boyoung

AU - Choi, Donghoon

AU - Lee, Moon Hyoung

AU - Kim, Young Hoon

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N2 - Background: Although open irrigation tip catheters (OITC) are effective in producing transmural radiofrequency (RF) lesions, they have the potential for fluid overload or excessive tissue damage. Methods and Results: The 203 patients with non-paroxysmal atrial fibrillation (NPAF; 85.2% males, 55.2±10.6 years old) who underwent RF catheter ablation (RFCA) were analyzed retrospectively. Clinical outcomes and complications were compared between RFCA using OITC (n=92) and that using conventional catheters (CONC; n=111). Both the total procedure time (P<0.01) and fluoroscopic time (P<0.001) were shorter in the OITC group than in the CONC group. Total fluid loading during RFCA with OITC was 3.2±0.9L, and the average body weight increase was 1.8±1.2 kg. Symptomatic pulmonary edema and/or pleural effusion occurred in 3.3% of patients who had a bigger left atrium (P=0.005), longer duration of ablation procedure (P=0.002), higher post-RFCA serum pro-ANP level (P<0.001), and longer hospitalization (P<0.01). Conclusions: RFCA for NPAF using OITC results in a shorter procedure time compared with CONC. However, patients with a large left atrium and a large amount of fluid (>4L) infused via the OITC need to be carefully monitored to prevent pulmonary edema or pleural effusion because of fluid overload.

AB - Background: Although open irrigation tip catheters (OITC) are effective in producing transmural radiofrequency (RF) lesions, they have the potential for fluid overload or excessive tissue damage. Methods and Results: The 203 patients with non-paroxysmal atrial fibrillation (NPAF; 85.2% males, 55.2±10.6 years old) who underwent RF catheter ablation (RFCA) were analyzed retrospectively. Clinical outcomes and complications were compared between RFCA using OITC (n=92) and that using conventional catheters (CONC; n=111). Both the total procedure time (P<0.01) and fluoroscopic time (P<0.001) were shorter in the OITC group than in the CONC group. Total fluid loading during RFCA with OITC was 3.2±0.9L, and the average body weight increase was 1.8±1.2 kg. Symptomatic pulmonary edema and/or pleural effusion occurred in 3.3% of patients who had a bigger left atrium (P=0.005), longer duration of ablation procedure (P=0.002), higher post-RFCA serum pro-ANP level (P<0.001), and longer hospitalization (P<0.01). Conclusions: RFCA for NPAF using OITC results in a shorter procedure time compared with CONC. However, patients with a large left atrium and a large amount of fluid (>4L) infused via the OITC need to be carefully monitored to prevent pulmonary edema or pleural effusion because of fluid overload.

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