First Experience Using a Novel Variable Loop Catheter for Mapping and Pulsed Field Ablation of Atrial Fibrillation

Figures

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  FIGURE 1. Electroanatomical mapping utilizing high‐density multielectrode catheters and the multi‐eletrode variable loop catheter. Overlay of electroanatomical maps with a high‐density multielectrode catheter (glass mode) and the VLC device (color‐coded map) (A). All PVs were successfully engaged with the VLC device for mapping. Localization of ablation spots is visualized by grid tags (B). Post‐ablation remapping with a multielectrode catheter demonstrates good correlation between low‐voltage areas and ablation tags (C). [Colour figure can be viewed at wileyonlinelibrary.com]

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  FIGURE 2. Correlation of electroanatomic mapping and ablation localization. Representative electroanatomical maps with the VLC device (A) and a multielectrode catheter (B) as well as an overlay of both maps with integrated ablation tags (C). The map shown in (A) depicts a case in which intubation of the LIPV was not successful with the VLC device. Nevertheless, remapping after ablation with a high‐density mapping catheter (B) demonstrated successful ablation in this case. [Colour figure can be viewed at wileyonlinelibrary.com]

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  FIGURE 3. Left atrial substrate modification with posterior wall ablation using the multielectrode variable loop catheter. Electroanatomical maps with multielectrode catheter (A), VLC device (B), overlay maps with integrated ablation tags (C), and post‐ablation remap demonstrating homogenous low‐voltage (C) in a patient receiving PVI and box isolation. Notably, complete intubation of the RSPV was not possible with the VLC device. [Colour figure can be viewed at wileyonlinelibrary.com]

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  FIGURE 4. Anatomic specimen of the left atrium demonstrating catheter placement. Representative images showing catheter placement inside the LA of an anatomic specimen. (A) Placement of the VLC in an ostial position at the right inferior pulmonary vein (RIPV), utilizing the contraction knob to adjust the device's diameter. (B) Placement of the VLC in an antral position after retraction from the ostial location and increase in the device diameter. The placement of a dedicated mapping catheter at the RIPV ostium is also shown. IAS = intraatrial septum, LIPV = left inferior pulmonary vein, LSPV = left superior pulmonary vein, RIVP = right inferior pulmonary vein, RSPV = right superior pulmonary vein, VLC = variable loop catheter. [Colour figure can be viewed at wileyonlinelibrary.com]