Research About Steerable Sheath Catheter Navigation Used In Atrial Fibrillation Ablation

Objective: To compare the efficiency of using manually controlledsteerable sheath catheter navigation to that of using a nonsteerable sheath inatrial fibrillation (AF) mapping and ablation．Methods:48patients with paroxysmal AF who underwent catheterablation by using manually controlled steerable sheath catheter navigationbetween October2012to November2013in the First Affiliated Hospital ofGuangxi Medical University were enrolled into group of AgilisTM，and another27patients with paroxysmal AF who underwent catheter ablation by using anonsteerable sheath between June2011to September2012were enrolled intogroup of Swartz．Catheter ablation was conducted under CARTO or Ensite3000three-dimensional mapping system using CARTO-Merge or Ensite Fusiontechnique，steerable sheath catheter navigation（AgilisTM） were used in thegroup of AgilisTM，and nonsteerable sheath catheter navigation（Swartz wereused in the group of Swartz．For evaluing the two sheath catheter，the data ofprocedure time，fluoroscopy time，radiofrequency (RF) burning time，pulmonary vein potential changes during procedure，spontaneous dissociated firing from thepulmonary veins，complications and recurrence rate were compared．Twoindependent samples t-test was used to compare the two sets of measurementdata；chi-square test was used to compare the pulmonary vein potential changes，spontaneous dissociated firing from the pulmonary veins，the success rate andthe incidence of complications between the two groups． When P＜0.05difference was statistically significant．Results：Between the group of Swartz and AgilisTM， procedure durationand radiofrequency burning time did not differ significantly(215.56±43.29minvs.195.31±56.44min，P＞0.05；40.33±10.30min vs.42.81±18.96min，P＞0.05),whereas fluoroscopy time was lower in the steerable sheath group (41.42±13.74min vs.25.19±10.72min，P＜0.05)．During the circumferential pulmonary veinisolation procedure，the Swartz group has30sides of pulmonary vein potentialsgradually fall after it become extending，the AgilisTMgroup has63sides of pul-monary vein potentials gradually fall after it become extending，the differencewas not statistically significant(P＞0.05)．After the completion of the pulmonaryvein isolation，the Swartz group has spontaneous pulmonary vein potentialsappear in10sides pulmonary veins，the AgilisTMgroup has spontaneouspulmonary vein potentials appear in32sides pulmonary veins，the differencewas statistically significant (P＜0.05) between the two groups．The complicationrate was the same in both groups．Single procedure success (freedom from AF)was significantly higher in patients ablated with a steerable sheath (84.78%vs.65.21%after3months，P＜0.05)．Conclusion: Using manually controlled steerable sheath resulted in a shor-ter fluoroscopy time，more spontaneous pulmonary vein potentials and lower re-currence rate，with comparable procedure time，radiofrequency burning time and complication of circumferential left atrial PV ablation in AF mapping and abla-tion approach．It can improve the AF ablation outcomes and reduce the recurre-nce rate．...