{"id":"4cd6d406b62e","type":"article","url":"https://hartvaat.nl/2019/08/01/eenvoudige-techniek-voor-pvi-van-linker-longvenen-gerandomiseerde-studie/","title":"Eenvoudige techniek voor PVI van linker longvenen: gerandomiseerde studie","title_en":"Evaluation of a simple technique aiming at optimizing point-by-point isolation of the left pulmonary veins: a randomized study.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euz115","source_url":"https://doi.org/10.1093/europace/euz115","authors":["Maria Kyriakopoulou","Teresa Strisciuglio","Milad El Haddad","Jan De Pooter","Alexandre Almorad","Katarina Van Beeumen","Philippe Unger","Yves Vandekerckhove","René Tavernier","Mattias Duytschaever","Sébastien Knecht"],"significance":4,"published":"2019-08-01","source_date":"2019-08-01","image":"","kennis":[],"congress":"","summary_en":"A randomised study evaluated a simplified catheter stabilisation technique for point-by-point isolation of the left pulmonary veins during AF ablation. The approach aims to improve anterior wall contact and procedural consistency.","created":"2026-07-03T10:28:04Z","updated":"2026-07-03T13:27:15Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde studie naar een vereenvoudigde techniek voor point-by-point isolatie van de linker longvenen bij AF-ablatie.","abstract_original":"AIMS: We sought to evaluate the efficacy and the safety of a simple technique for stabilizing the ablation catheter during anterior pulmonary vein (PV) encirclement in patients ablated for paroxysmal atrial fibrillation. This consisted of bending the ablation catheter in the left atrium, creating a loop that was cautiously advanced together with the long sheath at the ostium and then within the left superior PV. The curve was then progressively released to reach a stable contact with the anterior part of the left PVs. METHODS AND RESULTS: Eighty consecutive patients (age 64 ± 11 years, left atrial diameter 43 ± 8 mm) undergoing 'CLOSE'-guided PV isolation were prospectively randomized into two groups depending on whether the loop technique was used or not. When using the loop technique, the encirclement of the left PVs was shorter [20 min (interquartile range, IQR 17-24) vs. 26 min (IQR 18-33), P < 0.01] with a high rate of first pass isolation [(100%) vs. (97%), P = 0.9] and adenosine proof isolation [(93%) vs. (95%), P = 0.67]. Most specifically, at the anterior part of the left PVs, there were less dislocations [0 (IQR 0-0) vs. 1 (IQR 0-4), P < 0.001], radiofrequency duration was shorter (272 ± 85 s vs. 378 ± 122 s, P < 0.001), force-time integral was higher [524 gs (IQR 427-687) vs. 398 gs (IQR 354-451), P < 0.001], average contact force was higher [20 g (IQR 13-27) vs. 11g (IQR 9-16), P < 0.001], and impedance drop was higher [12 Ω (IQR 9-19) vs. 10 Ω (IQR 7-14), P < 0.001]. CONCLUSION: This study describes a simple technique to facilitate catheter stability at the anterior part of the left PVs, resulting in more efficient left PV encirclement without compromising safety."}