Cardiac Consult: A Cleveland Clinic Podcast for Healthcare Professionals Global EP Summit: AF Ablation
May 25, 2023
Ayman Hussein, MD, a cardiac electrophysiologist renowned for his expertise in atrial fibrillation ablation, delves into the intricacies of single-shot radiofrequency techniques. He discusses the challenges of RF catheter navigation and highlights innovations like the phased RF circular catheters and their clinical outcomes. Hussein also covers the safety concerns around silent cerebral emboli and recalls the N-Contact/N-Mark catheter due to complications. He introduces the Heliostar RF balloon system and reviews early trial results, emphasizing the need for further research.
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Single-Shot Tools Aim To Simplify PVI
- Single-shot systems were developed to simplify and speed pulmonary vein isolation compared with point-by-point RF catheters.
- Cryoballoon dominated clinical adoption while single-shot RF techniques lagged behind despite decades of development.
PVAC Showed Acute Success But Lacked Long-Term Data
- The PVAC phased RF circular catheter produced high acute PV isolation rates and shorter procedure times.
- However, durability and long-term arrhythmia-free survival remained unproven and required further research.
PVAC Associated With Cerebral Embolism Risk
- PVAC raised major concerns for asymptomatic cerebral embolism with rates varying widely across studies.
- Despite redesigns (gold electrodes, altered bipole interactions) it still showed higher ACE rates than cryo without clear benefit.