title: Initial results of efficacy of left linear ablation using a novel simultaneous multielectrode ablation catheter.
abstract: BACKGROUND
  Creating complete linear block with point-by-point ablation is challenging in the left atrium (LA). The purpose of this study was to evaluate the efficacy of LA linear ablation using a hexapolar linear multielectrode mapping/ablation catheter.
  
  
  RESULTS
  Seventeen patients (age 57 ± 10, 14 male, 6 paroxysmal AF (PAF)) were studied and underwent linear ablation at the mitral isthmus (MI) and LA roof. Ablation was performed with 90 second, 60 °C applications of duty-cycled bipolar/unipolar radiofrequency in a 1:1 ratio simultaneously at all selected electrode pairs. The result could not be evaluated in 2 patients because AF persisted despite cardioversion. Roof line block was confirmed in 9 of 15 (60%) patients. The mean number of applications and the procedural time with and without block was 5.4 ± 2.4 and 4.5 ± 2.2 applications, and 15 ± 8 and 13 ± 7 minutes. MI block was confirmed in 4 of 15 (27%) patients. The mean number of RF applications with and without block was 5.3 ± 2.2 and 9.9 ± 4.4 applications, and the procedural time was 20 ± 9 and 27 ± 10 minutes, respectively. For patients with underlying persistent AF, power was lower than those with PAF but improved when ablation was performed in sinus rhythm. Char was observed in 2 cases; however, no procedure-related complications were observed.
  
  
  CONCLUSIONS
  In our initial experience, a linear multielectrode catheter using duty-cycled bipolar and unipolar RF energy was inferior to conventional single point irrigated ablation in achieving LA linear block. However, successful linear block was obtained within a short period of time, when it was achieved.
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and the Université Victor Segalen Bordeaux II, Bordeaux, France. mshinsuke@k3.dion.ne.jp
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.forename: Nick
authors.initials: N
authors.lastname: Linton
authors.forename: Amir S
authors.initials: AS
authors.lastname: Jadidi
authors.forename: Isabelle
authors.initials: I
authors.lastname: Nault
authors.forename: Matthew
authors.initials: M
authors.lastname: Wright
authors.forename: Andrei
authors.initials: A
authors.lastname: Forclaz
authors.forename: Lena
authors.initials: L
authors.lastname: Rivard
authors.forename: Xingpeng
authors.initials: X
authors.lastname: Liu
authors.forename: Ashok
authors.initials: A
authors.lastname: Shah
authors.forename: Olivier
authors.initials: O
authors.lastname: Xhaet
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000628:therapy*; D016279:Atrial Function, Left / Q000502:physiology*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods*; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome