title: Initial results of using a novel irrigated multielectrode mapping and ablation catheter for pulmonary vein isolation.
abstract: BACKGROUND
  Pulmonary vein isolation (PVI) as a cornerstone for catheter ablation of atrial fibrillation (AF) remains a complex and time-consuming procedure.
  
  
  OBJECTIVE
  To assess feasibility, safety, and acute efficacy of a novel irrigated multielectrode ablation catheter guided by an electroanatomic mapping system for PVI in patients with paroxysmal AF.
  
  
  METHODS
  Twenty-five consecutive patients (60 ± 10 years) with paroxysmal AF underwent PVI by using a novel decapolar mapping and ablation catheter (nMARQ catheter, Biosense Webster Inc, Diamond Bar, CA). Ablation was guided by electroanatomic mapping allowing radiofrequency (RF) energy delivery in the antral region of pulmonary veins (PVs) from 10 irrigated electrodes simultaneously. The day after ablation, cardiac magnetic resonance imaging was performed routinely in order to assess for potential acute PV stenosis.
  
  
  RESULTS
  Overall, 97 of 97 (100%) targeted PVs could be isolated with a mean of 27 ± 11 RF applications and a mean total burning time of 15 ± 6 minutes per patient. The total procedure time from femoral vein access to catheter withdrawal was 110 ± 31 minutes, including a mean total fluoroscopy time of 23 ± 9 minutes. On average, 6 ± 3 RF impulses with a maximum of 25 W were applied per vein. After a short learning curve, procedure, fluoroscopy, and total burning times decreased to 94 ± 16, 16 ± 3, and 9 ± 2 minutes, respectively (P < .05). Entrance and exit blocks could be verified by placing the ablation catheter into 90 of 97 (93%) PVs in 18 of 25 (72%) patients. No procedure-related complications were observed, especially no acute PV stenosis could be detected.
  
  
  CONCLUSIONS
  The use of a novel irrigated multielectrode ablation system for PVI is feasible and safe, resulting in acute isolation of all targeted PVs with no complications and short procedure times. Sustainability of these initial results has to be confirmed in long-term efficacy and follow-up trials.
authors: Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany. Electronic address: dong-in.shin@med.uni-duesseldorf.de.
authors: Dong-In
authors: DI
authors: Shin
authors: Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
authors: Kiriakos
authors: K
authors: Kirmanoglou
authors: Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
authors: Christian
authors: C
authors: Eickholt
authors: Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
authors: Jan
authors: J
authors: Schmidt
authors: Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
authors: Lukas
authors: L
authors: Clasen
authors: Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
authors: Britta
authors: B
authors: Butzbach
authors: Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
authors: Tienush
authors: T
authors: Rassaf
authors: Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
authors: Marc
authors: M
authors: Merx
authors: Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
authors: Malte
authors: M
authors: Kelm
authors: Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
authors: Christian
authors: C
authors: Meyer
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D004566:Electrodes; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006329:Heart Conduction System / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
keywords: Atrial fibrillation; Catheter ablation; Multielectrode ablation catheter