• Giuseppe Stabile, Ermenegildo De Ruvo, Massimo Grimaldi, Giovanni Rovaris, Ezio Soldati, Matteo Anselmino, Francesco Solimene, Assunta Iuliano, Luigi Sciarra, Vincenzo Schillaci, Maria Grazia Bongiorni, Fiorenzo Gaita, and Leonardo Calò.
• Clinica Mediterranea, Naples, Italy. Electronic address: gmrstabile@tin.it.
• Heart Rhythm. 2015 Aug 1; 12 (8): 1782-8.

BackgroundPulmonary vein (PV) isolation is the cornerstone of catheter ablation in patients with atrial fibrillation (AF). "Single-shot" ablation devices have been recently engineered.ObjectivesWe report on the safety and efficacy of a novel ablation catheter for PV isolation in patients with AF.MethodsOne hundred eighty consecutive patients (58 ± 10 years, 125 male, 31% with structural heart disease) referred for paroxysmal (140) or persistent (40) AF underwent PV isolation by an open-irrigated mapping and radiofrequency (RF) decapolar ablation catheter in 7 centers. Ablation was guided by electroanatomic mapping, allowing RF energy delivery in the antral region of PVs from 10 irrigated electrodes simultaneously.ResultsMean overall procedure time was 113 ± 53 minutes with a mean fluoroscopy time of 13.1 ± 8.4 minutes. The use of a preablation PV imaging related to a significant reduction in fluoroscopy time (from 14.7 ± 9.7 to 8.7 ± 6.6, P < .001). Mean ablation time was 12.5 ± 5.1 minutes, and 98% of the targeted veins were isolated with a mean of 23.4 ± 6.3 RF pulses per patient. In only 4 patients (2.2%) a single-point ablation strategy was required to achieve PV isolation. One groin hematoma and 1 PV stenosis were reported. During a mean follow-up of 13.9 ± 8.2 months 38 of 140 patients (27%) with paroxysmal AF and 12 of 40 patients (30%) with persistent AF had an atrial arrhythmia relapse (P = .671).ConclusionsIn this multicenter registry, irrigated multielectrode RF ablation proved feasible, achieving a high rate of isolated PVs. Procedural and fluoroscopy times and success rates were comparable with other techniques, with a low complication rate.Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

27 keywords...

hide…