Abstract
Catheter ablation is an established treatment option for symptomatic atrial fibrillation (AF). Pulmonary vein (PV) electrical isolation has become the cornerstone of catheter ablation for AF. Multiple strategies have been performed including single tip ablation catheters or new tools using a “single-shot” approach including either balloon technology or multipolar ablation catheters. The purpose of this study was to investigate the efficacy and safety of a new circular irrigated multielectrode ablation catheter guided by an electroanatomic mapping system (nMARQ™, Biosense Webster, Diamond Bar, USA). Consecutive patients who underwent pulmonary vein isolation due to symptomatic atrial fibrillation refractory to antiarrhythmic drugs with nMARQ ™ cathter between May-2013 and April-2014 in two centers were included in the study. Pulmonary vein islation was evaluated using nMARQ ™ catheter exclusively. Cardiac magnetic resonance imaging was performed in order to assess for potential acute PV stenosis in one of the centers. 40 patients (30 center A, 10 center B) were included (33 men, mean age 56.4 years, SD 8.6, rank 36-76). Echocardiography data: mean LVEF 61.6, SD 6.8 (all patients > 50%, but one, 40% - tschymiocardiopathy). Mean LA diameter 41.78 mm, SD 4.1, rank 34-55. 158/160 pulmary veins were succesfully isolated (98.75 %). Total procedure time was 82.4 minutes (SD 6.4), including total fluoroscopy time of 32.4 minutes (SD 1.5). There was one major complication (cardiac tamponade). After a mean follow-up period of 6.4 months (SD 3.3, 31 patients > 6 months), 37 patients remain asymptomatic, with no documentation of atrial fibrillation recurrence. There were no pulmonary vein stenosis in the 16 patients who underwent CRM. PV isolation with circular irrigated multielectrode ablation catheter (nMARQ ™) is a feasible technique with a high acute success rate, and low procedure times. The vast majority of patients remain asymptomatic in the short and median-term follow-up. There were no pulmonary vein stenosis due to ablation. Although there were no major complication in our series, safety profile of this new technology must be proven in wider clinical studies.
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