Multi-electrode PulmonarY Vein Isolation Versus Single Tip Wide Area Catheter Ablation for Paroxysmal Atrial Fibrillation (PAF)

Inclusion criteria

• History of symptomatic paroxysmal atrial fibrillation defined as:

• Self-terminating AF with episodes lasting no more than seven consecutive days before spontaneous conversion back to sinus rhythm
• Documentation of one or more events with PAF tracings by ECG, event recordings, pacemaker strips or monitor rhythm strips within the past year
• AF symptoms defined as the manifestation of any of the following:

• Palpitations
• Fatigue
• Exertional dyspnea
• Effort intolerance
• Age between 18 and 70
• Willingness, ability and commitment to participate in baseline and follow-up evaluations for the full length of the study

Exclusion criteria

• Structural heart disease of clinical significance including:

• Previous cardiac surgery (excluding CABG)
• Symptoms of congestive heart failure including, but not limited to, NYHA Class III or IV CHF and/or documented ejection fraction < 40% measured by acceptable cardiac testing
• Left atrial diameter of > 50mm as measured in the parasternal long axis on transthoracic echocardiogram
• Stable/unstable angina or ongoing myocardial ischemia
• Myocardial infarction (MI) within three months of enrollment
• Aortic or mitral valve disease > Grade II
• Congenital heart disease (not including ASD or PFO without a right to left shunt) where the underlying abnormality increases the risk of an ablative procedure
• Prior ASD or PFO closure with a device using a percutaneous approach
• Hypertrophic cardiomyopathy (LV wall thickness > 1.5 cm)
• Pulmonary hypertension (mean or systolic PA pressure >50mm Hg on Doppler echo
• Prior ablation for arrhythmias other than AF within the past three months
• Prior left sided AF ablation
• Enrollment in any other ongoing arrhythmia study protocol Any ventricular tachyarrhythmias currently being treated where the arrhythmia or the management may interfere with this study