Isolation of Pulmonary Veins With PVAC GOLD in Elderly Patients

Objective: Pulmonary vein isolation (PVI) for atrial fibrillation (AF) has become progressively safer and more effective with advances in single-shot devices. The aim of this study was to compare catheter ablation (CA) of second-generation pulmonary vein ablation catheter (PVAC) Gold technique versus clinical treatment in elderly patients (≥ 65 years old) with symptomatic paroxysmal AF (PAF) without structural heart diseases.

Methods: Prospective randomized study that selected consecutive patients with paroxysmal atrial fibrillation older than 65 years-old in two groups: (1) PVAC ablation group and (2) antiarrhythmic drugs therapy group. Primary outcomes were AF recurrences, progression to persistent AF forms. As secondary outcomes, changes in Mini-Mental State Examination and AF Quality of Life Score were accessed.This study doesn't include payment of participants. All patients signed the informed consent.

Inclusion criteria

• Indication for isolation of pulmonary veins
• Age >= 65 years old
• Association with the following characteristics:

• Symptomatic Atrial Fibrillation;
• Sinusal Rhythm maintenance failure for at least 1 Antiarrythmic Drugs;
• Diagnosis of Atrial Fibrilation on resting eletrocardiogram and/or 24h Holter.

Exclusion criteria

• Prior Atrial Fibrillation ablation;
• Atrial Fibrillation permanent and/or persistent;
• Left atrial size > 55 mm;
• Mechanical prothetic mitral valve replacement;
• Presence of atrial thrombus;
• Cardiac invasive procedure < 90 days;
• Cerebral embolism < 6 months;
• Hypertrophic cardiomyopathy;
• Contraindications to antiocoagulation and cerebral MRI.