Abstract 4111: Acute Results of Pulmonary Vein Isolation Using a Single Combined Mapping and Ablation Catheter and Conventional Fluoroscopy Only
Catheter-based isolation of pulmonary veins (PVs) has emerged as established therapy to treat patients with paroxysmal atrial fibrillation. We attempted to simplify the interventional procedure by using a single novel multipolar catheter for mapping and ablation, guided by fluoroscopy only. Forty-eight patients with paroxysmal atrial fibrillation scheduled for PV isolation were screened by cardiac computed tomography for anatomical suitability to undergo a simplified procedure with the High Density (HD) Mesh Ablator Catheter as the only left atrial device. The procedure was finally performed in 26 patients (12 males, mean age 61 years) matching the criteria of 4 clearly separated PVs with an ostial diameter of 15 – 25 mm. The remaining 22 patients served as control group and were treated by a three-dimensional mapping system guided ablation using a decapolar spiral catheter for mapping and a conventional irrigated tip catheter for ablation. In all 26 patients, all four PVs could be accessed and mapped with the HD Mesh Ablator Catheter. Electrical isolation could be achieved in 99/102 (97%) PVs revealing potentials. Mean total procedure time and fluoroscopy time were 187 ± 36 and 35 ± 10 min, and were significantly shorter compared to the control group of conventionally treated patients (232 ± 31 and 41 ± 10, p < 0.00005 and p < 0.05, respectively). Preliminary follow up data using 48-hours ECG recording and clinical history did not reveal a statistically significant difference between the two different ablation strategies after 3 months: Eleven out of 18 patients versus 11 out of 17 patients were classified as event-free. The remaining patients are within the “blanking period” of 2 months. The single catheter approach using the HD Mesh Ablator Catheter for mapping and ablation reveals a high acute success rate despite the reduced complexity of the procedure. Long-term data on clinical success are needed to justify this simplified approach.