title: Effect of Different Ablation Settings on Acute Complications Using the Novel Irrigated Multipolar Radiofrequency Ablation Catheter (nMARQ).
abstract: BACKGROUND
  Single-shot ablation devices for pulmonary vein isolation (PVI) in patients with symptomatic atrial fibrillation (AF) have been increasingly used in clinical practice.
  
  
  OBJECTIVE
  A novel mapping-system integrated irrigated multipolar circular ablation catheter (nMARQ) has been introduced for PVI but data on larger patient cohorts on acute safety and efficacy are lacking.
  
  
  METHODS
  A total of 145 consecutive patients undergoing AF ablation treated with the nMARQ underwent endoscopic evaluation of esophageal thermal damage (EDEL) and brain MRI for detection of silent cerebral events (SCE). During the course of our experience different modifications of the ablation strategy, including energy delivery at the left atrial posterior wall, were evaluated.
  
  
  RESULTS
  Effective PVI was achieved in 99% of all PVs during a mean procedure-duration of 115 (±36) minutes and ablation-duration of 18 (±8) minutes. Acute major complications occurred in 3 patients (2.1%) and asymptomatic complications like SCE in 26% and EDEL in 21%. There was a significant reduction in EDEL when not using a thermal esophageal probe (0% vs. 28%, P < 0.0001). Ablation under oral anticoagulation led to lower SCE incidences compared to interrupted anticoagulation regimen (15% vs. 31%, P = 0.7). Out of 65 patients with completed 12-month follow-up, 43 (66%) were in stable sinus rhythm.
  
  
  CONCLUSIONS
  PVI using the nMARQ is safe and effective in patients with symptomatic AF. Not using an esophageal temperature probe during ablation has relevantly reduced the incidence of EDEL. Ablations under continued oral anticoagulation have reduced incidence of SCE. Further studies on long-term efficacy are needed.
authors.affiliation: Heart Center Bad Neustadt, Bad Neustadt, Germany.|Ruhr-University Bochum, Bochum, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Deneke
authors.affiliation: Heart Center Bad Neustadt, Bad Neustadt, Germany.|Ruhr-University Bochum, Bochum, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Müller
authors.affiliation: Heart Center Bad Neustadt, Bad Neustadt, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Halbfaß
authors.affiliation: Heart Center Bad Neustadt, Bad Neustadt, Germany.
authors.forename: Atilla
authors.initials: A
authors.lastname: Szöllösi
authors.affiliation: Heart Center Bad Neustadt, Bad Neustadt, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Roos
authors.affiliation: Heart Center Bad Neustadt, Bad Neustadt, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Krug
authors.affiliation: Heart Center Bad Neustadt, Bad Neustadt, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Fochler
authors.affiliation: Heart Center Bad Neustadt, Bad Neustadt, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Schade
authors.affiliation: Department of Radiology, Bad Neustadt, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmitt
authors.affiliation: Department of Radiology, Bad Neustadt, Germany.
authors.forename: Georgios
authors.initials: G
authors.lastname: Christopoulos
authors.affiliation: Ruhr-University Bochum, Bochum, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mügge
authors.affiliation: Heart Center Bad Neustadt, Bad Neustadt, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Nentwich
mesh_terms: D000208:Acute Disease; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data*; D015331:Cohort Studies; D015897:Comorbidity; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D011667:Pulmonary Veins / Q000601:surgery; D012307:Risk Factors; D007507:Therapeutic Irrigation / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: atrial fibrillation ablation; esophageal lesions; nMARQ; silent cerebral events; single-shot ablation device