title: Pulmonary vein isolation during cryoballoon ablation using the novel Achieve inner lumen mapping catheter: a feasibility study.
abstract: OBJECTIVE
  Cryoballoon (CB) ablation has proven very effective in achieving pulmonary vein isolation (PVI). The Achieve catheter (AC) is a novel inner lumen catheter designed to be used in conjunction with the CB, which serves the double purpose of a guidewire and a mapping catheter. We aimed to evaluate the feasibility of CB ablation in conjunction with the novel AC, in terms of PVI and safety in a series of patients affected by drug resistant paroxysmal atrial fibrillation (AF).
  
  
  RESULTS
  Seventy patients (49 male) affected by paroxysmal AF were assigned to CB PVI using the AC as a mapping catheter. Patients underwent loop-Holter monitoring 1, 3 and 6 months after ablation. Isolation occurred in 98% of PVs with the CB-AC association without having switching to a regular guidewire. Pulmonary vein isolation could be documented by real-time (RT) recordings in 47% (132) of veins. Time to isolation was significantly longer in PVs exhibiting early left atrium-PV reconnection if compared with veins with sustained isolation (117 ± 25 s vs. 59 ± 25 s; P< 0,005). No serious complications occurred; four transient phrenic nerve palsies occurred all resolving completely before the end of the procedure.
  
  
  CONCLUSIONS
  Cryoballoon ablation in conjunction with the novel AC is feasible, safe, and most importantly affords PVI in nearly all veins without having to switch to a regular guidewire. However, RT recordings could be documented in only 47% of pulmonary veins.
authors.affiliation: Cardiovascular Division, Heart Rhythm Management Center, UZ Brussel - Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium. gbchier@yahoo.it
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.forename: Mehdi
authors.initials: M
authors.lastname: Namdar
authors.forename: Sjoerd
authors.initials: S
authors.lastname: Westra
authors.forename: Malte
authors.initials: M
authors.lastname: Kuniss
authors.forename: Andrea
authors.initials: A
authors.lastname: Sarkozy
authors.forename: Fatih
authors.initials: F
authors.lastname: Bayrak
authors.forename: Danilo
authors.initials: D
authors.lastname: Ricciardi
authors.forename: Ruben
authors.initials: R
authors.lastname: Casado-Arroyo
authors.forename: Moises
authors.initials: M
authors.lastname: Rodriguez Manero
authors.forename: Jayakeerthi Y
authors.initials: JY
authors.lastname: Rao
authors.forename: Joep
authors.initials: J
authors.lastname: Smeets
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000295:instrumentation*; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D003452:Cryosurgery / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D005260:Female; D006329:Heart Conduction System / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D016896:Treatment Outcome