INTRODUCTION: Catheter-based pulmonary vein isolation (PVI) is an established therapy to treat patients with paroxysmal atrial fibrillation. We evaluated the efficacy of a simplified interventional procedure for PVI by using a single mesh catheter for mapping as well as ablation and with guidance of fluoroscopic imaging only. METHODS AND RESULTS: Forty-eight patients with paroxysmal atrial fibrillation were screened by cardiac computed tomography for their anatomical suitability to undergo PVI with the high-density mesh ablator catheter as the only left atrial device. The procedure was performed in 26 patients (12 males, mean age 61 years) who met the criteria of four clearly separated pulmonary veins (PVs) with an ostial diameter of 15-25 mm. No three-dimensional mapping systems or additional ablation devices were used. In all 26 patients, all four PVs could be accessed and mapped with the high-density mesh ablator catheter. Electrical isolation was achieved in 99 of 102 (97%) of the pulmonary veins that revealed PV potentials. Mean total procedure time and fluoroscopy time were 187 +/- 36 minutes and 34.6 +/- 10.0 minutes, respectively. CONCLUSION: The single-catheter approach using the high-density mesh ablator catheter for mapping as well as ablation reveals a high acute success rate of PVI while, at the same time, reducing the complexity of the procedure, and the procedure time. Long-term data on clinical success are needed to justify this simplified approach.
INTRODUCTION: Catheter-based pulmonary vein isolation (PVI) is an established therapy to treat patients with paroxysmal atrial fibrillation. We evaluated the efficacy of a simplified interventional procedure for PVI by using a single mesh catheter for mapping as well as ablation and with guidance of fluoroscopic imaging only. METHODS AND RESULTS: Forty-eight patients with paroxysmal atrial fibrillation were screened by cardiac computed tomography for their anatomical suitability to undergo PVI with the high-density mesh ablator catheter as the only left atrial device. The procedure was performed in 26 patients (12 males, mean age 61 years) who met the criteria of four clearly separated pulmonary veins (PVs) with an ostial diameter of 15-25 mm. No three-dimensional mapping systems or additional ablation devices were used. In all 26 patients, all four PVs could be accessed and mapped with the high-density mesh ablator catheter. Electrical isolation was achieved in 99 of 102 (97%) of the pulmonary veins that revealed PV potentials. Mean total procedure time and fluoroscopy time were 187 +/- 36 minutes and 34.6 +/- 10.0 minutes, respectively. CONCLUSION: The single-catheter approach using the high-density mesh ablator catheter for mapping as well as ablation reveals a high acute success rate of PVI while, at the same time, reducing the complexity of the procedure, and the procedure time. Long-term data on clinical success are needed to justify this simplified approach.
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Heart Rhythm Date: 2017-05-12 Impact factor: 6.343
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; José Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: Heart Rhythm Date: 2012-03-01 Impact factor: 6.343
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Europace Date: 2018-01-01 Impact factor: 5.214
Authors: Petra Maagh; Marc van Bracht; Thomas Butz; Hans-Joachim Trappe; Axel Meissner Journal: J Interv Card Electrophysiol Date: 2010-07-16 Impact factor: 1.900