title: Pulmonary vein isolation with a new multipolar irrigated radiofrequency ablation catheter (nMARQ™): feasibility, acute and short-term efficacy, safety, and impact on postablation silent cerebral ischemia.
abstract: BACKGROUND
  Simultaneous multipolar ablation catheters have been proposed to simplify pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (AF). Recently, a new multipolar irrigated radiofrequency (RF) ablation catheter (nMARQ™, Biosense Webster Inc., Diamond Bar, CA, USA) combining both 3-dimensional electroanatomic mapping and multipolar open-irrigated ablation capability has been developed. Aim of our study was to assess feasibility, acute and short-term success and safety of PVI by the use of this new technology with particular regard to the incidence of postablation silent cerebral ischemia (SCI).
  
  
  RESULTS
  Twenty-five patients (76% males; age 57 ± 13 years) with paroxysmal AF underwent PVI using the nMARQ™ catheter. PVI, confirmed by Lasso catheter mapping, was achieved in 100 out of 102 pulmonary veins (98%) identified, and final PVI was obtained in 24 out of 25 (96%) patients. The overall concordance between Lasso and nMARQ™ signals in demonstrating PVI was 78%. No major procedural complications occurred and no patient suffered SCI, on the basis of cerebral magnetic resonance imaging performed before and after the procedure. Following a 6-month follow-up, 17/25 (68%) patients remained free from AF without antiarrhythmic drugs.
  
  
  CONCLUSIONS
  In our preliminary experience, PVI with nMARQ™ catheter appears to be feasible and safe, without incidence of SCI. Long-term clinical efficacy has to be evaluated in further studies.
authors: Cardiology Division, Cardinal Guglielmo Massaia Hospital, Asti, Italy.
authors: Marco
authors: M
authors: Scaglione
authors: Domenico
authors: D
authors: Caponi
authors: Matteo
authors: M
authors: Anselmino
authors: Francesca
authors: F
authors: Di Clemente
authors: Alessandro
authors: A
authors: Blandino
authors: Federico
authors: F
authors: Ferraris
authors: Paolo
authors: P
authors: Di Donna
authors: Elisa
authors: E
authors: Ebrille
authors: Franck
authors: F
authors: Halimi
authors: Jean F
authors: JF
authors: Leclercq
authors: Costanza
authors: C
authors: Iunco
authors: Carloeugenio
authors: C
authors: Vaudagna
authors: Federico
authors: F
authors: Cesarani
authors: Fiorenzo
authors: F
authors: Gaita
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology*; D017115:Catheter Ablation / Q000009:adverse effects* / 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 / Q000009:adverse effects / Q000295:instrumentation*; D016896:Treatment Outcome
keywords: asymptomatic cerebral embolism; atrial fibrillation; catheter ablation; nMARQ™; pulmonary vein isolation; silent cerebral ischemia