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Acute and Mid-Term Results after Pulmonary Veins Isolation Using a Novel Circular Irrigated Multielectrode Mapping and Ablation Catheter (nmarq)

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World Journal of Cardiovascular Diseases 2016年第12期6卷 477-488页

作者： Ibrahim Marai Mahmoud Suleiman Jonathan Lessick Miry Blich Sobhi Abadi Monther Boulos Division of Pacing and Electrophysiology Rambam Health Care Campus and Bruce Rappaport Faculty of Medicine Technion-Israel Institute of Technology Haifa Israel Department of Diagnostic Imaging Rambam Health Care Campus and Bruce Rappaport Faculty of Medicine Technion-Israel Institute of Technology Haifa Israel

Background: Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation in both paroxysmal and persistent AF. However, this procedure is still challenging and time consuming. Objective: The aim of this study was to present our approach for PVI using a novel circular irrigated multielectrode mapping and ablation catheter (nmarqTM) and to present acute and mid-term results. Methods: The study included 31 consecutive patients with symptomatic AF (4 had persistent and 27 had paroxysmal AF) who underwent PVI using the nmarqTM catheter. Circular ablation was guided by CT image integrated into fast anatomical map and by intra cardiac echo. Isolation of pulmonary veins was identified using the nmarqTM catheter if it was possible to advance it into the veins, otherwise Lasso catheter was used. Patients were followed up to 20 months. Results: PVI was achieved in 119 (98%) out of 121 pulmonary veins identified, and final PVI was obtained in 30 (97%) out of 31 patients. Lasso catheter was needed for PVI confirmation in 16 (52%) patients. Touch up ablation using standard catheter guided by Lasso catheter was needed in 4 (13%) patients. Pericardial tamponade occurred in 1 patient who was treated with pericardiocentesis. No other major complications were detected. During follow-up (mean 15.9 ± 3.6 months, range 9 - 20 months), 4 (13%) patients had recurrence of atrial tachyarrhythmia. Conclusion: PVI using the novel nmarqTM catheter is safe with good acute and mid-term efficacy. Long term follow up trials are needed.

关键词： Atrial Fibrillation Catheter Ablation Image Integration nmarq Lasso

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