title: First results and follow-up of a second-generation circular mapping and ablation catheter.
abstract: OBJECTIVE
  Pulmonary vein isolation with radiofrequency energy is widely used as a strategy for catheter ablation of atrial fibrillation (AF). Anatomically designed catheters have been developed to increase the efficiency of AF ablation procedures. The second-generation circular ablation catheter, PVAC GOLD, was re-designed to improve energy delivery and mitigate emboli. We investigated the procedural efficiency, biophysics, and chronic efficacy of PVAC GOLD in patients with AF.
  
  
  METHODS
  We consecutively enrolled 40 patients (60 ± 11 years) with highly symptomatic, drug refractory AF. The first 20 patients were treated with the first-generation PVAC. The subsequent 20 patients were treated with the second-generation PVAC GOLD catheter. All patients were followed up at 3, 6, and 12 months.
  
  
  RESULTS
  All 164 targeted PVs were successfully isolated. Ablations performed with PVAC GOLD showed a significant reduction in total number of ablations needed for PVI, fluoroscopy, and procedure times compared to PVAC (34.7 ± 7.0 vs. 27.0 ± 6.5; p = 0.009), fluoroscopy (29.5 ± 9.5 vs. 23.4 ± 7.0; p = 0.026), and procedure time (93.8 ± 18.9 vs. 83.1 ± 10.6; p = 0.033). PVAC GOLD showed improved biophysics including a reduction of low power ablations and an increase in mean effective energy delivery. At 12 months follow-up, AF recurrence rates were comparable in the two groups (35 vs. 30 %; p = 0.735). There were no adverse events.
  
  
  CONCLUSIONS
  The redesigned PVAC GOLD catheter demonstrates a reduction in radiofrequency ablation and procedure time and improved biophysics while maintaining chronic efficacy compared to the first-generation PVAC.
authors.affiliation: Klinikum Bayreuth, Department of Cardiology and Electrophysiology, Bayreuth, Germany. stefan.weber@klinik.uni-regensburg.de.|University of Regensburg and Praxis für Kardiologie und Rhythmologie, Weichser Weg 5, 93059, Regensburg, Germany. stefan.weber@klinik.uni-regensburg.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Weber
authors.affiliation: Klinikum Bayreuth, Department of Cardiology and Electrophysiology, Bayreuth, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Höher
authors.affiliation: Klinikum Bayreuth, Department of Cardiology and Electrophysiology, Bayreuth, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Schultes
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; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012008:Recurrence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D016896:Treatment Outcome
keywords: Atrial fibrillation; Catheter ablation; Multi-electrode ablation catheter; Phased RF