Pulmonary vein isolation using a circular, open irrigated mapping and ablation catheter (nMARQ): a report on feasibility and efficacy.

Autor:	Zellerhoff S; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France stephan.zellerhoff@ukmuenster.de., Daly M; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France., Lim HS; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France., Denis A; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France., Komatsu Y; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France., Jesel L; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France., Derval N; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France., Sacher F; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France., Cochet H; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France., Knecht S; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France., Yiem S; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France., Hocini M; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France., Haïssaguerre M; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France., Jaïs P; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Victor Segalen Bordeaux II, Avenue de Magellan, 33604 Bordeaux-Pessac, France INSERM U1045-L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
Jazyk:	angličtina
Zdroj:	Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2014 Sep; Vol. 16 (9), pp. 1296-303. Date of Electronic Publication: 2014 Jun 18.
DOI:	10.1093/europace/euu133
Abstrakt:	Aims: Pulmonary vein isolation (PVI) is the mainstay of interventional treatment of paroxysmal atrial fibrillation (PAF). We report on the feasibility and efficacy of a novel, open-irrigated mapping and radiofrequency (RF) ablation catheter. Methods and Results: Thirty-nine consecutive patients (pts; age 60 ± 10 years, 8 females) suffering from drug-refractory PAF referred for PVI were included in this prospective study. Pulmonary vein isolation was performed with the use of a novel 10-pole circular, open-irrigated mapping and ablation catheter (nMARQ, Biosense Webster). Outcome parameters were the acute success rate in establishing complete PVI and the rate of sustained sinus rhythm (SR) during follow-up (FU). Ten patients underwent a repeat procedure for recurrent AF. Ninety-eight percent of the PVs could be acutely isolated using solely the nMARQ catheter by applying a mean total of 10.0 ± 4.6 min of RF energy. The mean total procedure duration was 86 ± 29 min, and the mean fluoroscopy time was 22.2 ± 6.5 min, respectively. Transient reconnection provoked by adenosine was observed in 10 of 24 patients, most frequently in the right superior PV. Cardiac tamponade related to transseptal puncture occurred in one patient. Reconnected PVs could be identified as a source of recurrent AF in 9 of 10 patients undergoing a repeat procedure. Single and multiple procedure success rates during a mean FU of 140 ± 75 days were 66 and 77%, respectively. Conclusion: Irrigated multi-electrode RF ablation is fast and effective, providing a high rate of isolated PVs without the need of touch-up lesions. Success rates were comparable with other techniques with a low complication rate. Recurrences of AF were mainly due to recovered pulmonary vein/left atrium conduction. (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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