A single-catheter approach using a high-density mesh ablator achieved electrical isolation in 97% (99 of 102) of targeted pulmonary veins in patients with paroxysmal atrial fibrillation.
Does a single high-density mesh ablator catheter achieve acute electrical isolation of pulmonary veins in patients with paroxysmal atrial fibrillation?
A single high-density mesh ablator catheter approach for mapping and ablation achieves a high acute success rate of pulmonary vein isolation in selected patients with paroxysmal atrial fibrillation.
INTRODUCTION: Catheter-based pulmonary vein isolation (PVI) is an established therapy to treat patients with paroxysmal atrial fibrillation. We evaluated the efficacy of a simplified interventional procedure for PVI by using a single mesh catheter for mapping as well as ablation and with guidance of fluoroscopic imaging only. METHODS AND RESULTS: Forty-eight patients with paroxysmal atrial fibrillation were screened by cardiac computed tomography for their anatomical suitability to undergo PVI with the high-density mesh ablator catheter as the only left atrial device. The procedure was performed in 26 patients (12 males, mean age 61 years) who met the criteria of four clearly separated pulmonary veins (PVs) with an ostial diameter of 15-25 mm. No three-dimensional mapping systems or additional ablation devices were used. In all 26 patients, all four PVs could be accessed and mapped with the high-density mesh ablator catheter. Electrical isolation was achieved in 99 of 102 (97%) of the pulmonary veins that revealed PV potentials. Mean total procedure time and fluoroscopy time were 187 +/- 36 minutes and 34.6 +/- 10.0 minutes, respectively. CONCLUSION: The single-catheter approach using the high-density mesh ablator catheter for mapping as well as ablation reveals a high acute success rate of PVI while, at the same time, reducing the complexity of the procedure, and the procedure time. Long-term data on clinical success are needed to justify this simplified approach.
Steinwender et al. (Thu,) conducted a other in Paroxysmal atrial fibrillation (n=26). Pulmonary vein isolation using a single high-density mesh ablator catheter was evaluated on Electrical isolation of pulmonary veins. A single-catheter approach using a high-density mesh ablator achieved electrical isolation in 97% (99 of 102) of targeted pulmonary veins in patients with paroxysmal atrial fibrillation.
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