Saagar Mahida1, Darren A Hooks1, Karin Nentwich2, G Andre Ng3, Massimo Grimaldi4, Dong-In Shin5, Nicolas Derval1, Frederic Sacher1, Benjamin Berte1, Seigo Yamashita1, Arnaud Denis1, Mélèze Hocini1, Thomas Deneke2, Michel Haissaguerre1, Pierre Jais1. 1. Hôpital Cardiologique du Haut-Lévêque and Université de Bordeaux, Bordeaux, Equipex MUSIC ANR-11-EQPX-0030, IHU LIRYC ANR-10-IAHU-04, Germany. 2. Heart-Center Bad Neustadt, Clinic for Invasive Electrophysiology, Bad Neustadt, Germany. 3. NIHR Leicester Cardiovascular Biomedical Research Unit, Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Leicester, UK. 4. Francesco Miulli Hospital, Acquaviva delle Fonti, Bari, Italy. 5. Cardiac Arrhythmia Service, Divison of Cardiology, Pulmonology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
Abstract
BACKGROUND: nMARQ is a multipolar catheter designed to simultaneously ablate at multiple sites around the pulmonary vein (PV) circumference with a single radiofrequency application. We sought to define the safety and efficacy of atrial fibrillation (AF) ablation with the nMARQ catheter. METHODS: In a multicenter study, patients with drug-refractory AF were included. Procedural outcomes were documented at 1 year. RESULTS: 374 patients underwent PV isolation using nMARQ (age 60 ± 10 years, 264 male), of whom 263 patients had paroxysmal AF (PAF), while 111 patients had persistent AF. A total of 1,468 of 1,474 veins (99.6%) were isolated with the nMARQ catheter alone. Thirty-five (13%) PAF patients and 30 (27%) persistent AF patients underwent additional ablation at non-PV sites (2.4 ± 1.4 non-PV sites). Procedure time for PV isolation only was 1.9 ± 0.7 hours (fluoroscopy 24 ± 14 minutes). Procedure time for PV isolation and non-PV ablation was 2.4 ± 1.0 hours (fluoroscopy 30 ± 23 minutes). Major adverse events occurred in two patients (0.5%); one esophago-pericardial fistula and a second, mortality due to sepsis of unknown cause. One-year follow-up data were available in 65 (25%) PAF and 20 (18%) persistent AF patients. Forty-two (65%) PAF and 13 (65%) persistent AF patients were free of arrhythmia at 1 year. In patients undergoing repeat procedures (n = 17) the most frequent points of PV reconnection were: anterior RSPV, inferior RIPV, and superior LSPV. CONCLUSIONS: AF ablation with nMARQ is associated with short procedure times and high acute success rates. Further research is necessary to more clearly define long-term outcome.
BACKGROUND:nMARQ is a multipolar catheter designed to simultaneously ablate at multiple sites around the pulmonary vein (PV) circumference with a single radiofrequency application. We sought to define the safety and efficacy of atrial fibrillation (AF) ablation with the nMARQ catheter. METHODS: In a multicenter study, patients with drug-refractory AF were included. Procedural outcomes were documented at 1 year. RESULTS: 374 patients underwent PV isolation using nMARQ (age 60 ± 10 years, 264 male), of whom 263 patients had paroxysmal AF (PAF), while 111 patients had persistent AF. A total of 1,468 of 1,474 veins (99.6%) were isolated with the nMARQ catheter alone. Thirty-five (13%) PAF patients and 30 (27%) persistent AFpatients underwent additional ablation at non-PV sites (2.4 ± 1.4 non-PV sites). Procedure time for PV isolation only was 1.9 ± 0.7 hours (fluoroscopy 24 ± 14 minutes). Procedure time for PV isolation and non-PV ablation was 2.4 ± 1.0 hours (fluoroscopy 30 ± 23 minutes). Major adverse events occurred in two patients (0.5%); one esophago-pericardial fistula and a second, mortality due to sepsis of unknown cause. One-year follow-up data were available in 65 (25%) PAF and 20 (18%) persistent AFpatients. Forty-two (65%) PAF and 13 (65%) persistent AFpatients were free of arrhythmia at 1 year. In patients undergoing repeat procedures (n = 17) the most frequent points of PV reconnection were: anterior RSPV, inferior RIPV, and superior LSPV. CONCLUSIONS:AF ablation with nMARQ is associated with short procedure times and high acute success rates. Further research is necessary to more clearly define long-term outcome.
Authors: Ka H C Li; Mei Dong; Mengqi Gong; George Bazoukis; Ishan Lakhani; Yan Y Ting; Sunny H Wong; Guangping Li; William K K Wu; Vassilios S Vassiliou; Martin C S Wong; Konstantinos Letsas; Yimei Du; Victoria Laxton; Bryan P Yan; Yat S Chan; Yunlong Xia; Tong Liu; Gary Tse Journal: Front Physiol Date: 2018-05-22 Impact factor: 4.566