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J Interv Card Electrophysiol. 2010 Dec;29(3):179-85. doi: 10.1007/s10840-010-9518-0. Epub 2010 Oct 5.

Pulmonary vein isolation with Mesh Ablator versus cryoballoon catheters: 6-month outcomes.

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  • 1Cardiovascular Division, City Hospital Linz, Krankenhausstrasse 9, 4021 Linz, Austria. robert.hofmann@akh.linz.at

Abstract

INTRODUCTION:

We sought to compare the results of pulmonary vein (PV) ablation using the high-density Mesh Ablator catheter (MESH) versus the cryoballoon (CRYO).

METHODS AND RESULTS:

From August 2007 to November 2009, all patients with paroxysmal atrial fibrillation scheduled for a first procedure of PV isolation were screened by cardiac computed tomography for anatomical suitability to undergo ablation with a circumferential ostial ablation catheter. The procedure was finally performed in 79 out of 120 patients matching the criteria of four clearly separated PVs with an ostial diameter of 15-25 mm. The first consecutive 43 patients were treated with the MESH; the following 36 consecutive patients were treated with the CRYO. The procedures were performed with up to 900 s of either pulsed radiofrequency energy delivered by the MESH or cryoenergy applied with the CRYO. The clinical success rate was evaluated 6 months after a single procedure. Isolation of all PVs could be achieved in 40 patients (93%) in the MESH group compared to 31 patients (89%) in the CRYO group (p = ns). Major complications consisted of one tamponade in the MESH group and one reversible phrenic nerve palsy in the CRYO group. After 6 months, the clinical success rate was 44% (19/43 P) in the MESH versus 69% (25/36 P) in the CRYO group (p < 0.05).

CONCLUSION:

Both methods of simplified circumferential PV ablation reveal a high acute success rate. The clinical 6-month results of the MESH are statistically significant inferior compared to the CRYO.

[PubMed - indexed for MEDLINE]
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