First Experiences for Pulmonary Vein Isolation with the High‐Density Mesh Ablator (HDMA): A Novel Mesh Electrode Catheter for Both Mapping and Radiofrequency Delivery in a Single Unit
- 23 March 2009
- journal article
- Published by Wiley in Journal of Cardiovascular Electrophysiology
- Vol. 20 (4), 359-366
- https://doi.org/10.1111/j.1540-8167.2008.01335.x
Abstract
Interventional therapy of atrial fibrillation (AF) is often associated with long examination and fluoroscopy times. The use of mapping catheters in addition to the ablation catheter requires multiple transseptal sheaths for left atrial access.The purpose of this prospective study was to evaluate feasibility and safety of pulmonary vein (PV) isolation using the high-density mesh ablator (HDMA), a novel single, expandable electrode catheter for both mapping and radiofrequency (RF) delivery at the left atrium/PV junctions.Twenty-six patients with highly symptomatic paroxysmal AF (14, 53.8%) and persistent AF (12, 46.2%) were studied. Segmental PV isolation via the HDMA was performed using a customized pulsed RF energy delivery program (target temperature 55-60 degrees C, power 70-100 W, 600-900 seconds RF application time/PV).All 104 PVs in 26 patients could be ablated by the HDMA. Segmental PV isolation was achieved with a mean of 3.25 +/- 1.4 RF applications for a mean of 603 +/- 185 seconds. Entrance conduction block was obtained in 94.2% of all PV. The mean total procedure and fluoroscopy time was 159.0 +/- 32 minutes and 33.5 +/- 8.6 minutes, respectively. None of the patients experienced severe acute complications. After 3 months no PV stenosis was observed, and 85.6% and 41.6% of the patients with PAF and persistent AF, respectively, did not report symptomatic AF.In this first study of PV isolation using the HDMA, our findings suggest that this method is safe and yields good primary success rates. The HDMA simplifies AF ablation, favorably impacting procedure and fluoroscopy times.Keywords
This publication has 24 references indexed in Scilit:
- Balloon catheter ablation to treat paroxysmal atrial fibrillation: What is the level of pulmonary venous isolation?Heart Rhythm, 2008
- Integration of Three‐Dimensional Left Atrial Magnetic Resonance Images into a Real‐Time Electroanatomic Mapping System: Validation of a Registration MethodPacing and Clinical Electrophysiology, 2008
- Long-term follow-up after radiofrequency catheter ablation for atrial fibrillationEP Europace, 2008
- Characteristics and Outcome in Patients Receiving Multiple (More Than Two) Catheter Ablation Procedures for Paroxysmal Atrial FibrillationJournal of Cardiovascular Electrophysiology, 2007
- Isolating the Posterior Left Atrium and Pulmonary Veins with a “Box” Lesion Set: Use of Epicardial Ablation to Complete Electrical IsolationJournal of Cardiovascular Electrophysiology, 2007
- Impact of Heart Rhythm Status on Registration Accuracy of the Left Atrium for Catheter Ablation of Atrial FibrillationJournal of Cardiovascular Electrophysiology, 2007
- A Novel Mesh Electrode Catheter for Mapping and Radiofrequency Delivery at the Left Atrium-Pulmonary Vein Junction: A Single-Catheter Approach to Pulmonary Vein Antrum IsolationJournal of Cardiovascular Electrophysiology, 2007
- Coronary Sinus and Fossa Ovalis Ablation: Effect on Interatrial Conduction and Atrial FibrillationJournal of Cardiovascular Electrophysiology, 2007
- Freedom From Atrial Tachyarrhythmias After Catheter Ablation of Atrial FibrillationCirculation, 2005
- Complete Isolation of Left Atrium Surrounding the Pulmonary VeinsCirculation, 2004