Abstract 15850: Cerebral Microembolization During Pulmonary Vein Isolation: A Comparison of Different Ablation Techniques
Background: Comparing different ablation technologies for atrial fibrillation the use of the pulmonary vein ablation catheter (PVAC) and the GENius 14.3 generator was associated with the highest incidence of silent cerebral ischaemia. Software modifications of the GENius generator were implemented to reduce thrombogenicity of the PVAC. The nMARQ catheter, a new radiofrequency single-shot technique for pulmonary vein isolation (PVI) has been recently introduced. Data ont he comparison of the thromboembolic potentials of these single-shot ablation technologies are limited. We assessed the incidence of cerebral microemboli during PVI with the Cryoballoon catheter (CRYO), the PVAC and 3 different generations of the GENius ablator, and the nMARQ catheter.
Methods and results: 74 patients (mean age:58 SD:12 years; 51 male) with paroxysmal or persistent atrial fibrillation underwent PVI with CRYO (13 patients , Group 1), PVAC and the GENius 14.3 generator (7 patients, group 2), the GENius 14.4 ablator (37 patients, group 3), GENius15.0 generator (10 patients, group 4) and the nMARQ catheter (7 patients, group 5). Microembolic signals (MES) in the middle cerebral arteries were detected intraoperatively by transcranial Doppler. Figure 1. depicts the mean MES counts during the total procedure as well as during the energy delivery period for each ablation group.
Conclusion: Significant decrease in MES counts was observed with the newer generations of the GENius generator resulting in less MESs with the latest version than what was obtained with CRYO. Ablation with the nMARQ catheter produced MES counts comparable to the first generation of the GENius generator.
- © 2013 by American Heart Association, Inc.