{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T06:16:51Z","timestamp":1782713811015,"version":"3.54.5"},"reference-count":10,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The creation of effective and permanent lesions is a crucial factor in determining the success rate of atrial fibrillation (AF) ablation. By increasing the efficacy of radiofrequency (RF) energy\u2010mediated lesion formation, half\u2010normal saline (HNS) as an irrigant for open\u2010irrigated ablation catheters has the potential to reduce procedural times and improve acute and long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a double\u2010blind\u00a0randomized clinical trial of 99 patients undergoing first\u2010time RF catheter ablation for AF. Patients enrolled were randomly assigned in a 1:1 fashion to perform ablation using HNS or normal saline (NS) as an irrigant for the ablation catheter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The use of HNS is associated with shorter RF times (26 vs. 33\u2009min;<jats:italic>p<\/jats:italic>\u2009=\u2009.02) with comparable procedure times (104 vs. 104\u2009min). The rate of acute pulmonary vein reconnections (16% vs. 18%) was comparable, with a median of 1 vein reconnection in the HNS arm versus 2 in the NS arm. There was no difference in procedure\u2010related complications, including the incidence of postprocedural hyponatremia when using HNS. Over the 1\u2010year follow\u2010up, there is no significant difference between the HNS and NS with respect to the recurrence of any atrial arrhythmia (off antiarrhythmic drugs\u00a0[AAD]: 47% vs. 52%; hazard ratio [HR]: 1.17, 95% confidence interval [CI]: 0.66\u20132.06; off\/on AAD: 66% vs. 66%, HR: 1.06, 95% CI: 0.53\u20132.12), with a potential benefit of using HNS when considering the paroxysmal AF cohort (on\/off AAD 73% vs. 62%, HR: 0.72, 95% CI: 0.19\u20132.70).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a mixed cohort of patients undergoing first\u2010time AF ablation, irrigation of open\u2010irrigated RF ablation catheters with HNS is associated with shorter RF times, with a comparably low rate of procedure\u2010related complications. In the long term, there is no significant difference with respect to the recurrence of any atrial arrhythmia. Larger studies with a more homogeneous population are necessary to determine whether HNS improves clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14885","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T17:12:05Z","timestamp":1610730725000},"page":"973-981","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Half\u2010normal saline versus normal saline for irrigation of open\u2010irrigated radiofrequency catheters in atrial fibrillation ablation"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8174-7207","authenticated-orcid":false,"given":"Carola","family":"Gianni","sequence":"first","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Joseph","family":"Gallinghouse","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8547-025X","authenticated-orcid":false,"given":"Amin","family":"Al\u2010Ahmad","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney P.","family":"Horton","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"},{"name":"Department of Biomedical Engineering University of Texas Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane M.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. David","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed A.","family":"Bassiouny","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan C.","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Quintero Mayedo","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico G.","family":"Della Rocca","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6601-944X","authenticated-orcid":false,"given":"Sanghamitra","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"},{"name":"Dell Medical School University of Texas Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chintan","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6508-4047","authenticated-orcid":false,"given":"Luigi","family":"Di Biase","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"},{"name":"Montefiore Medical Center Albert Einstein College of Medicine Bronx New York USA"},{"name":"Department of Clinical and Experimental Medicine University of Foggia Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick M.","family":"Hranitzky","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier E.","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5487-0728","authenticated-orcid":false,"given":"Andrea","family":"Natale","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"},{"name":"HCA National Medical Director of Cardiac Electrophysiology USA"},{"name":"Interventional Electrophysiology Scripps Clinic La Jolla California USA"},{"name":"MetroHealth Medical Center Case Western Reserve University School of Medicine Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.112.004549"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B0-7216-0323-8\/50114-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2006.00533.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12682"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.03.006"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13185"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"A13166","DOI":"10.1161\/circ.134.suppl_1.13166","article-title":"Abstract 13166: externally irrigated radiofrequency 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