| Initial experience with the high-density mesh ablation catheter for pulmonary vein isolation. | |
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MedLine Citation:
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PMID: 19796345 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Yves De Greef; Dirk Stockman; Mattias Duytschaever; Yves Vandekerckhove; Rene Tavernier |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 32 ISSN: 1540-8159 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-02 Completed Date: 2009-12-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1286-93 Citation Subset: IM |
Affiliation:
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ZNA Middelheim, Cardiovasular Institute, Antwerp, Belgium. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Fibrillation
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diagnosis*,
surgery* Body Surface Potential Mapping / instrumentation* Catheter Ablation / instrumentation* Equipment Design Equipment Failure Analysis Female Heart Conduction System / surgery* Humans Male 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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