title: Comparison of PV signal quality using a novel circular mapping and ablation catheter versus a standard circular mapping catheter.
abstract: OBJECTIVE
  Recently, new catheter technologies have been developed for atrial fibrillation (AF) ablation. We investigate the diagnostic accuracy of a circular mapping and pulmonary vein ablation catheter (PVAC) compared with a standard circular mapping catheter (Orbiter) and the influence of filter settings on signal quality.
  
  
  METHODS
  After reconstruction of the left atrium by three-dimensional atriography, baseline PV potentials (PVP) were recorded consecutively with PVAC and Orbiter in 20 patients with paroxysmal AF. PVPs were compared and attributed to predefined anatomical PV segments. Ablation was performed in 80 PVs using the PVAC. If isolation of the PVs was assumed, signal assessment of each PV was repeated with the Orbiter. If residual PV potentials could be uncovered, different filter settings were tested to improve mapping quality of the PVAC. Ablation was continued until complete PV isolation (PVI) was confirmed with the Orbiter.
  
  
  RESULTS
  Baseline mapping demonstrated a good correlation between the Orbiter and PVAC. Mapping accuracy using the PVAC for mapping and ablation was 94% (74 of 79 PVs). Additional mapping with the Orbiter improved the PV isolation rate to 99%. Adjustment of filter settings failed to improve quality of the PV signals compared with standard filter settings.
  
  
  CONCLUSIONS
  Using the PVAC as a stand-alone strategy for mapping and ablation, one should be aware that in some cases, different signal morphology mimics PVI isolation. Adjustment of filter settings failed to improve signal quality. The use of an additional mapping catheter is recommended to become familiar with the particular signal morphology during the first PVAC cases or whenever there is a doubt about successful isolation of the pulmonary veins.
authors.affiliation: Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany. Christian.von-Bary@klinik.uni-regensburg.de
authors.forename: Christian
authors.initials: C
authors.lastname: von Bary
authors.forename: Sabine
authors.initials: S
authors.lastname: Fredersdorf-Hahn
authors.forename: Norbert
authors.initials: N
authors.lastname: Heinicke
authors.forename: Carsten
authors.initials: C
authors.lastname: Jungbauer
authors.forename: Peter
authors.initials: P
authors.lastname: Schmid
authors.forename: Günter A
authors.initials: GA
authors.lastname: Riegger
authors.forename: Stefan
authors.initials: S
authors.lastname: Weber
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000295:instrumentation* / Q000379:methods; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D057785:Catheters; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D018570:Risk Assessment; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome