Safety and efficacy of pulmonary vein isolation using a circular, open-irrigated mapping and ablation catheter: A multicenter registry

BACKGROUND Pulmonary vein (PV) isolation is the cornerstone of catheter ablation in patients with atrial fibrillation (AF). "Single-shot" ablation devices have been recently engineered. OBJECTIVES We report on the safety and efficacy of a novel ablation catheter for PV isolation in patients with AF. METHODS One hundred eighty consecutive patients (58 +/- 10 years, 125 male, 31% with structural heart disease) referred for paroxysmal (140) or persistent (40) AF underwent PV isolation by an open-irrigated mapping and radiofrequency (RF) decapolar ablation catheter in 7 centers. Ablation was guided by electroanatomic mapping, allowing RE energy delivery in the antral region of PVs from 10 irrigated electrodes simultaneously. RESULTS Mean overall procedure time was 113 +/- 53 minutes with a mean fluoroscopy time of 13.1 +/- 8.4 minutes. The use of a preablation PV imaging related to a significant reduction in fluoroscopy time (from 14.7 +/- 9.7 to 8.7 +/- 6.6, P < .001). Mean ablation time was 12.5 +/- 5.1 minutes, and 98% of the targeted veins were isolated with a mean of 23.4 +/- 6.3 RE pulses per patient. In only 4 patients (2.2%) a single-point ablation strategy was required to achieve PV isolation. One groin hematoma and 1 PV stenosis were reported. During a mean follow-up of 13.9 +/- 8.2 months 38 of 140 patients (27%) with paroxysmal AF and 12 of 40 patients (30%) with persistent AF had an atrial arrhythmia relapse (P = .671). CONCLUSIONS In this multicenter registry, irrigated multielectrode RE ablation proved feasible, achieving a high rate of isolated PVs. Procedural and fluoroscopy times and success rates were comparable with other techniques, with a low complication rate.