title: Effect of left atrial volume and pulmonary vein anatomy on outcome of nMARQ™ catheter ablation of paroxysmal atrial fibrillation.
abstract: OBJECTIVE
  Left atrial volume (LA) and pulmonary vein (PV) anatomy may potentially relate to technical challenges in achieving stable and effective catheter position in case of atrial fibrillation (AF) ablation by means of "one-shot" catheters. The aim of this study was to investigate whether LA volume and PV anatomy, evaluated by computed tomography (CT) or magnetic resonance (MR) prior to ablation, predict acute and midterm outcome of AF ablation by nMARQ™.
  
  
  METHODS
  We included 75 patients (mean age 58 ± 11 years, 67 % male) with symptomatic paroxysmal AF. All patients underwent CT/MR scanning prior to catheter ablation to evaluate LA volume and PV anatomy. All the patients underwent PV isolation by nMARQ™, an open-irrigated mapping and radiofrequency (RF) decapolar ablation catheter. Ablation was guided by electroanatomic mapping allowing RF energy delivery in the antral region of PVs from ten irrigated electrodes simultaneously.
  
  
  RESULTS
  Mean LA volume was 75 ± 40 ml. A normal anatomy (4 PVs) was documented in 40 (53 %) patients and abnormal anatomy (common truncus or accessory PVs) in 35 patients. Mean procedural and fluoroscopy times were 94 ± 55 and 8 ± 5 min, respectively, without significant differences among patients with normal or abnormal anatomy (92 ± 45 vs 95 ± 64 min, p = 0.85 and 6 ± 3 vs 8 ± 4 min, p = 0.65, respectively). Mean ablation time was 14 ± 3 min, and 99 % of the targeted veins were isolated with a mean of 23 ± 5 RF pulses per patient. After a mean follow-up of 17 ± 8 months, 23 (31 %) patients had an atrial arrhythmia recurrence. Neither LA volume nor PV anatomy was a predictor of outcome.
  
  
  CONCLUSIONS
  LA volume and PV anatomy did not affect procedural data and outcome in patients who underwent PV isolation by an open-irrigated mapping and RF decapolar ablation catheter.
authors.affiliation: Clinica Mediterranea, Napoli, Italy. gmrstabile@tin.it.
authors.forename: Giuseppe
authors.identifier: http://orcid.org/0000-0003-4646-0865
authors.initials: G
authors.lastname: Stabile
authors.affiliation: Dipartimento di Scienze Mediche, Università di Torino, Torino, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Anselmino
authors.affiliation: Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
authors.forename: Ezio
authors.initials: E
authors.lastname: Soldati
authors.affiliation: Policlinico Casilino, Roma, Italy.
authors.forename: Ermengildo
authors.initials: E
authors.lastname: De Ruvo
authors.affiliation: Clinica Montevergine, Mercogliano, AV, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Solimene
authors.affiliation: Clinica Mediterranea, Napoli, Italy.
authors.forename: Assunta
authors.initials: A
authors.lastname: Iuliano
authors.affiliation: Policlinico Casilino, Roma, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Sciarra
authors.affiliation: Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Bongiorni
authors.affiliation: Policlinico Casilino, Roma, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calò
authors.affiliation: Dipartimento di Scienze Mediche, Università di Torino, Torino, Italy.
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000379:methods; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011379:Prognosis; D011667:Pulmonary Veins / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D018511:Systems Integration; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anatomy; Atrial fibrillation; Catheter ablation; Midterm outcome; Multielectrode ablation catheter; Safety