Document Detail

Initial experience with the high-density mesh ablation catheter for pulmonary vein isolation.
MedLine Citation:
PMID:  19796345     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pulmonary vein isolation (PVI) is usually performed with multiple point-by-point radiofrequency ablation with a second multielectrode circular mapping catheter to validate isolation. We evaluated a 30-mm high-density mesh electrode (HDMA) for mapping and PVI in patients with recurrent atrial fibrillation (AF). METHODS: In 13 patients (validation group) up to three pulmonary veins (PVs) were targeted with the HDMA. A circular mapping catheter was used to validate PVI. PVI was completed with a CARTO-guided approach (Biosense Webster, Diamond Bar, CA, USA) followed by a voltage remap. In 11 patients (feasibility group) the HDMA catheter was evaluated as a stand-alone mapping and ablation tool. RESULTS: The diagnostic accuracy of the HDMA catheter to evaluate PVI was 100%. The encircled low-voltage area (<0.15 mV) after HDMA-guided PVI was smaller compared to CARTO-guided PVI. In the feasibility group 76% of the PVs could be isolated. Complete isolation of all PVs was feasible in five patients (45%) with a mean procedure and fluoroscopy time of respectively 180 +/- 39 minutes and 40 +/- 14 minutes. After 1 year 64% of the patients were free of symptomatic AF. CONCLUSIONS: The HDMA electrode is a reliable mapping tool to validate PVI. The majority of PVs can be isolated, but on a patient basis touch-up ablations are necessary in more than 50% of the cases. Therefore, modifications in catheter design are required. The small area of voltage abatement points to an ostial left atrium-pulmonary vein disconnection. Initial clinical results in a small number of patients are promising.
Yves De Greef; Dirk Stockman; Mattias Duytschaever; Yves Vandekerckhove; Rene Tavernier
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  32     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-02     Completed Date:  2009-12-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1286-93     Citation Subset:  IM    
ZNA Middelheim, Cardiovasular Institute, Antwerp, Belgium.
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MeSH Terms
Atrial Fibrillation / diagnosis*,  surgery*
Body Surface Potential Mapping / instrumentation*
Catheter Ablation / instrumentation*
Equipment Design
Equipment Failure Analysis
Heart Conduction System / surgery*
Middle Aged
Pilot Projects
Pulmonary Veins / surgery*
Reproducibility of Results
Sensitivity and Specificity
Surgical Mesh*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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