title: Validation of a novel spiral mapping catheter for real-time recordings from the pulmonary veins during cryoballoon ablation of atrial fibrillation.
abstract: BACKGROUND
  The Achieve mapping catheter allows real-time recordings from the pulmonary veins (PVs) during cryoballoon (CB) ablation of atrial fibrillation (AF).
  
  
  OBJECTIVE
  To assess the clinical applicability of the Achieve mapping catheter and the value of real-time recordings from the PVs during CB.
  
  
  METHODS
  Patients with paroxysmal AF undergoing CB ablation were studied. Recordings from the PVs were analyzed during (real-time recordings) and after CB ablation and validated by using a variable circumferential mapping catheter (Achieve group; n = 20). A comparison was made by using a group of patients in whom CB ablation with a guidewire and a variable circumferential mapping catheter was performed (Guidewire group; n = 20).
  
  
  RESULTS
  Forty patients (age 58±11 years; ejection fraction 0.59±0.07; left atrial size 40±6 mm) with paroxysmal AF were included. In the Achieve group, real-time recordings from the PVs could be obtained in 40 of 80 (50%) PVs and could be seen more often at the left-sided PVs (25 of 39, 64%) than at the right-sided PVs (15 of 41, 37%; P = .02). Validation with a standard circumferential mapping catheter confirmed PV isolation in 75 of 80 (93%) PVs. After a single procedure and a follow-up of 14±4 months, 25 of 40 (63%) patients were in sinus rhythm with no significant difference between groups.
  
  
  CONCLUSIONS
  The Achieve catheter can be used as a substitute for a guidewire during CB ablation, but real-time recordings can be obtained only in half of the PVs and are not sufficient to accurately confirm isolation of all PVs.
authors.affiliation: Division of Cardiology, University Hospital Basel, Basel, Switzerland. kuehnem@uhbs.ch
authors.forename: Michael
authors.initials: M
authors.lastname: Kühne
authors.forename: Sven
authors.initials: S
authors.lastname: Knecht
authors.forename: David
authors.initials: D
authors.lastname: Altmann
authors.forename: Peter
authors.initials: P
authors.lastname: Ammann
authors.forename: Beat
authors.initials: B
authors.lastname: Schaer
authors.forename: Stefan
authors.initials: S
authors.lastname: Osswald
authors.forename: Christian
authors.initials: C
authors.lastname: Sticherling
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D015331:Cohort Studies; D003452:Cryosurgery / Q000295:instrumentation* / Q000379:methods; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D016896:Treatment Outcome