TY - JOUR
T1 - Radiofrequency ablation of paroxysmal atrial fibrillation with the new irrigated multipolar nMARQ ablation catheter
T2 - Verification of intracardiac signals with a second circular mapping catheter
AU - Rosso, Raphael
AU - Halkin, Amir
AU - Michowitz, Yoav
AU - Belhassen, Bernard
AU - Glick, Aharon
AU - Viskin, Sami
PY - 2014/4
Y1 - 2014/4
N2 - Background: During radiofrequency (RF) ablation of paroxysmal atrial fibrillation, a circular multielectrode recording "lasso" catheter is generally positioned within each pulmonary vein (PV) to determine when pulmonary vein potentials (PVPs) are present and when they have been ablated. The new irrigated multipolar nMARQ circular ablation catheter is positioned within the left atrium to create contiguous circular ablation lines around each PV ostium. Objective: To determine whether the recordings obtained from the nMARQ catheter position around the PV ostium accurately reproduce the recordings obtained from a lasso catheter positioned within that vein. Methods: In 10 patients undergoing RF ablation of paroxysmal atrial fibrillation, we placed an nMARQ and a lasso catheter around and within each PV, respectively. Recordings obtained from both catheters at baseline and after RF ablation were compared. Results: At baseline, recordings of PVPs in both catheters were concordant in 92% of all PVs. However, after RF delivery, the concordance between the nMARQ and lasso recordings was poor. The discordant result most commonly observed was disappearance of "PVPs" from the nMARQ catheter with persistence of PVPs in the lasso catheter (12 of 39 [30%]). Conversely, the delivery of RF frequently resulted in fragmented electrograms (pseudo-PVPs) on the nMARQ catheter despite evidence of PV isolation by lasso catheter recordings. Conclusions: The use of an nMARQ catheter alone, as currently recommended, may lead to underestimation and overestimation of the number of RF applications required to achieve PV isolation.
AB - Background: During radiofrequency (RF) ablation of paroxysmal atrial fibrillation, a circular multielectrode recording "lasso" catheter is generally positioned within each pulmonary vein (PV) to determine when pulmonary vein potentials (PVPs) are present and when they have been ablated. The new irrigated multipolar nMARQ circular ablation catheter is positioned within the left atrium to create contiguous circular ablation lines around each PV ostium. Objective: To determine whether the recordings obtained from the nMARQ catheter position around the PV ostium accurately reproduce the recordings obtained from a lasso catheter positioned within that vein. Methods: In 10 patients undergoing RF ablation of paroxysmal atrial fibrillation, we placed an nMARQ and a lasso catheter around and within each PV, respectively. Recordings obtained from both catheters at baseline and after RF ablation were compared. Results: At baseline, recordings of PVPs in both catheters were concordant in 92% of all PVs. However, after RF delivery, the concordance between the nMARQ and lasso recordings was poor. The discordant result most commonly observed was disappearance of "PVPs" from the nMARQ catheter with persistence of PVPs in the lasso catheter (12 of 39 [30%]). Conversely, the delivery of RF frequently resulted in fragmented electrograms (pseudo-PVPs) on the nMARQ catheter despite evidence of PV isolation by lasso catheter recordings. Conclusions: The use of an nMARQ catheter alone, as currently recommended, may lead to underestimation and overestimation of the number of RF applications required to achieve PV isolation.
KW - Atrial fibrillation
KW - Pulmonary veins
KW - Radiofrequency ablation
UR - http://www.scopus.com/inward/record.url?scp=84897037721&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2013.12.029
DO - 10.1016/j.hrthm.2013.12.029
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AN - SCOPUS:84897037721
SN - 1547-5271
VL - 11
SP - 559
EP - 565
JO - Heart Rhythm
JF - Heart Rhythm
IS - 4
ER -