First data on cardiac mapping and outcome of pulmonary vein isolation using a novel ablation catheter with tip mini electrodes

Abstract

AimsPulmonary vein isolation (PVI) is a standard treatment of atrial fibrillation (AF). AF recurrence after PVI occurs in a substantial number of cases. A novel ablation catheter equipped with mini-electrodes (ME) may facilitate PVI. Our study evaluated outcome after PVI with the ME catheter compared to a standard catheter. MethodsPatients undergoing PVI with the ME catheter were compared to a control group ablated with a standard contact force sensing catheter. Freedom of AF after 12 months was the study endpoint. Additionally, low voltage areas (LVA) <0.5 mV were identified with a circular mapping catheter (CMC) and the ablation catheter in each group. LVA were compared between the maps obtained with the CMC and the ME or standard catheter, respectively. ResultsA total of 110 patients underwent PVI with ME catheter (n = 59) or the standard catheter (n = 51). Procedure duration (117.4 ± 43 vs. 103.1 ± 32.8 min, p = 0.15), radiation dose (1135.6 ± 1125.7 vs. 1078.8 ± 951.4 μGy/m2, p = 0.91), incidence of complications and 12-month success rate (64.4 vs 72.5%, p = 0.36) were not significantly different between the groups. LVA were significantly smaller when obtained with the standard catheter compared to the CMC (14 ± 13 vs. 58.5 ± 22.1 cm2, p < 0.001), while no such difference was seen for mapping with the ME compared to the CMC (37 ± 30.3 vs. 33.4 ± 39 cm2, p = 0.4). ConclusionClinical outcomes are comparable between ME catheter and a standard contact force sensing catheter. Furthermore, better LVA detection points to improved mapping capabilities of the ME catheter.