Abstract 4109: First experiences for Pulmonary Vein Isolation with the High Density Mesh Ablator

Abstract

Interventional therapy of atrial fibrillation (AF) still is a complex procedure often associated with long examination- and fluoroscopy times. The use of mapping catheters in addition to the ablation catheter requires multiple transseptal sheats for left atrial access. The purpose of this prospective study was to evaluate feasibility and safety of pulmonary vein (PV) isolation using the high density mesh ablator (HDMA), a novel single, expandable electrode catheter for both mapping and radiofrequency (RF) delivery at the left atrium/PV junctions. 26 patients (PTS) with highly symptomatic paroxysmal AF (14, 53.8%) and persistent AF (12, 46.2%) were studied. Segmental PV isolation via the HDMA was performed using a customized pulsed RF energy delivery program (target temperature 55– 60 degrees, power 70 –100 Watt, 600 –900 seconds RFapplication time/PV). All 104 PV in 26 PTS could successfully be ablated by the HDMA. Segmental PV isolation was achieved with a mean of 3.25±1.4 RF applications for a mean of 603±185 sec. Entrance conduction block was obtained in >94% of all PV. Mean total procedure and fluoroscopy time was 159.0±32 min and 33.5±8.6 min respectively. None of the PTS experienced severe complications. In this first study of PV isolation using the HDMA, our findings suggest that this method is safe and yields good primary success rates. Anatomical orientation and signal quality were good, allowing for excellent electrophysiological control. The HDMA simplifies the complex procedure of AF ablation, favorably impacting procedure and fluoroscopy times. Further studies are required to assess the long-term outcome.