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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 
 CIRCULATION JOURNAL, Vol.74(4) : 644-649, 2010 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Atrial Fibrillation/surgery* ; Catheter Ablation/adverse effects ; Catheter Ablation/instrumentation ; Catheter Ablation/methods* ; Catheterization/adverse effects ; Catheterization/instrumentation* ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pleural Effusion/epidemiology ; Pulmonary Edema/epidemiology ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Young Adult
Atrial fibrillation ; Catheter ablation ; Irrigation tip catheter
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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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jong Seoung(박종성)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Lee, Moon-Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hwang, Eui Seock(황의석)
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