title: Pulmonary vein isolation using a circular, open irrigated mapping and ablation catheter (nMARQ): a report on feasibility and efficacy.
abstract: OBJECTIVE
  Pulmonary vein isolation (PVI) is the mainstay of interventional treatment of paroxysmal atrial fibrillation (PAF). We report on the feasibility and efficacy of a novel, open-irrigated mapping and radiofrequency (RF) ablation catheter.
  
  
  RESULTS
  Thirty-nine consecutive patients (pts; age 60 ± 10 years, 8 females) suffering from drug-refractory PAF referred for PVI were included in this prospective study. Pulmonary vein isolation was performed with the use of a novel 10-pole circular, open-irrigated mapping and ablation catheter (nMARQ, Biosense Webster). Outcome parameters were the acute success rate in establishing complete PVI and the rate of sustained sinus rhythm (SR) during follow-up (FU). Ten patients underwent a repeat procedure for recurrent AF. Ninety-eight percent of the PVs could be acutely isolated using solely the nMARQ catheter by applying a mean total of 10.0 ± 4.6 min of RF energy. The mean total procedure duration was 86 ± 29 min, and the mean fluoroscopy time was 22.2 ± 6.5 min, respectively. Transient reconnection provoked by adenosine was observed in 10 of 24 patients, most frequently in the right superior PV. Cardiac tamponade related to transseptal puncture occurred in one patient. Reconnected PVs could be identified as a source of recurrent AF in 9 of 10 patients undergoing a repeat procedure. Single and multiple procedure success rates during a mean FU of 140 ± 75 days were 66 and 77%, respectively.
  
  
  CONCLUSIONS
  Irrigated multi-electrode RF ablation is fast and effective, providing a high rate of isolated PVs without the need of touch-up lesions. Success rates were comparable with other techniques with a low complication rate. Recurrences of AF were mainly due to recovered pulmonary vein/left atrium conduction.
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France stephan.zellerhoff@ukmuenster.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: Zellerhoff
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France.
authors.forename: Matthew
authors.initials: M
authors.lastname: Daly
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France.
authors.forename: Han S
authors.initials: HS
authors.lastname: Lim
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Denis
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Komatsu
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Jesel
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Hubert
authors.initials: H
authors.lastname: Cochet
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Knecht
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France.
authors.forename: Sunthareth
authors.initials: S
authors.lastname: Yiem
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000295:instrumentation*; D017115:Catheter Ablation / 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*; D007507:Therapeutic Irrigation / Q000295:instrumentation*; D016896:Treatment Outcome
keywords: Atrial fibrillation; Catheter ablation; Technology