title: Safety and efficacy of pulmonary vein isolation using a circular, open-irrigated mapping and ablation catheter: A multicenter registry.
abstract: BACKGROUND
  Pulmonary vein (PV) isolation is the cornerstone of catheter ablation in patients with atrial fibrillation (AF). "Single-shot" ablation devices have been recently engineered.
  
  
  OBJECTIVE
  We report on the safety and efficacy of a novel ablation catheter for PV isolation in patients with AF.
  
  
  METHODS
  One hundred eighty consecutive patients (58 ± 10 years, 125 male, 31% with structural heart disease) referred for paroxysmal (140) or persistent (40) AF underwent PV isolation by an open-irrigated mapping and radiofrequency (RF) decapolar ablation catheter in 7 centers. Ablation was guided by electroanatomic mapping, allowing RF energy delivery in the antral region of PVs from 10 irrigated electrodes simultaneously.
  
  
  RESULTS
  Mean overall procedure time was 113 ± 53 minutes with a mean fluoroscopy time of 13.1 ± 8.4 minutes. The use of a preablation PV imaging related to a significant reduction in fluoroscopy time (from 14.7 ± 9.7 to 8.7 ± 6.6, P < .001). Mean ablation time was 12.5 ± 5.1 minutes, and 98% of the targeted veins were isolated with a mean of 23.4 ± 6.3 RF pulses per patient. In only 4 patients (2.2%) a single-point ablation strategy was required to achieve PV isolation. One groin hematoma and 1 PV stenosis were reported. During a mean follow-up of 13.9 ± 8.2 months 38 of 140 patients (27%) with paroxysmal AF and 12 of 40 patients (30%) with persistent AF had an atrial arrhythmia relapse (P = .671).
  
  
  CONCLUSIONS
  In this multicenter registry, irrigated multielectrode RF ablation proved feasible, achieving a high rate of isolated PVs. Procedural and fluoroscopy times and success rates were comparable with other techniques, with a low complication rate.
authors.affiliation: Clinica Mediterranea, Naples, Italy. Electronic address: gmrstabile@tin.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Stabile
authors.affiliation: Policlinico Casilino, Rome, Italy.
authors.forename: Ermenegildo
authors.initials: E
authors.lastname: De Ruvo
authors.affiliation: Ospedale Miulli, Acquaviva Delle Fonti, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Grimaldi
authors.affiliation: Ospedale San Gerardo, Monza, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rovaris
authors.affiliation: Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
authors.forename: Ezio
authors.initials: E
authors.lastname: Soldati
authors.affiliation: Dipartimento di Scienze Mediche, Università di Torino, Turin, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Anselmino
authors.affiliation: Clinica Montevergine, Mercogliano, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Solimene
authors.affiliation: Clinica Mediterranea, Naples, Italy.
authors.forename: Assunta
authors.initials: A
authors.lastname: Iuliano
authors.affiliation: Policlinico Casilino, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Sciarra
authors.affiliation: Clinica Montevergine, Mercogliano, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Schillaci
authors.affiliation: Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Bongiorni
authors.affiliation: Dipartimento di Scienze Mediche, Università di Torino, Turin, Italy.
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.affiliation: Policlinico Casilino, Rome, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calò
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D004867:Equipment Design / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012042:Registries; D016896:Treatment Outcome
keywords: Atrial fibrillation; Catheter ablation; Midterm outcome; Multielectrode ablation catheter; Safety