title: Usefulness of intracardiac echocardiography during pulmonary vein isolation with the novel multipolar irrigated ablation catheter (nMARQ™).
abstract: BACKGROUND
  Previous studies reported the usefulness of an irrigated circular radiofrequency ablation catheter (nMARQ(TM), Biosense Webster) for pulmonary vein isolation (PVI). We evaluated the role of intracardiac echocardiography (ICE) to optimize the manipulation of nMARQ(TM) catheter.
  
  
  METHODS
  Thirty-seven patients (pts), (mean age 55 ± 12 years; 28 males) were enrolled to perform PVI. All pts underwent PVI with the nMARQ(TM) catheter. In 20 pts (group 1), we utilized ICE to guide nMARQ(TM) catheter positioning at the PV ostia; in the other 17 pts (group 2), nMARQ(TM) catheter was positioned at the PV ostia guided by fluoroscopy and TissueConnect(TM) technology.
  
  
  RESULTS
  Radiofrequency (RF) applications were significantly lower in group 1 compared to group 2 [left PVs: 6 (range 3 to 12) in group 1 and 12 (range 5 to 16) in group 2 (p < 0.001); right PVs: 7 (range 4 to 14) in group 1 and 10 (range 5 to 16) in group 2 (p = 0.04)]; similarly regarding the time of RF delivery [left PVs: 318 ± 194 s in group 1 vs. 542 ± 104 s in group 2 (p < 0.001); right PVs: 410 ± 270 s in group 1 vs. 550 ± 156 s in group 2 (p = 0.05)]. Fluoroscopy time (23 ± 9 min vs. 28 ± 5 min; p = 0.05), procedural time (83 ± 23 min vs. 160 ± 42 min; p < 0.001), and radiation dose (109 ± 20 Gy/cm(2) vs. 127 ± 29 Gy/cm(2); p = 0.04) were significantly lower in group 1 compared to group 2.
  
  
  CONCLUSIONS
  ICE might be a useful tool to guide nMARQ(TM) catheter position in the left atrium during atrial fibrillation (AF) ablation procedures.
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy. antonio.dellorusso@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Fassini
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Casella
authors.affiliation: Cardiovascular Science Department, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Monaco
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Riva
authors.affiliation: Clinica Montevergine, Mercogliano, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Romano
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Moltrasio
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Tundo
authors.affiliation: Clinica Montevergine, Mercogliano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Martino
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Majocchi
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Marino
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Russo
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pizzamiglio
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Del Giorno
authors.affiliation: Cardiovascular Science Department, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Gemma
authors.initials: G
authors.lastname: Pelargonio
authors.affiliation: St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, TX, USA.
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.affiliation: St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, TX, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging*; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: Atrial fibrillation ablation; Intracardiac echocardiography; nMARQTM ablation catheter