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Cardiac mapping and pulmonary vein isolation using a novel ablation catheter with tip minielectrodes
Author(s) -
Heringhaus Florian,
Lotz Tanja,
Loehr Lena,
Gelep Julia,
Lask Sebastian,
Kara Kaffer,
Mügge Andreas,
Wutzler Alexander
Publication year - 2017
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13185
Subject(s) - medicine , pulmonary vein , ablation , atrial fibrillation , catheter ablation , catheter , cardiology , electrode , nuclear medicine , surgery , chemistry
Background Pulmonary vein isolation (PVI) is a standard treatment for atrial fibrillation (AF). Identification of gaps in the ablation line is difficult. Tip‐ring electrograms from ablation catheters represent relative large areas of myocardial tissue. Recently, an ablation catheter with three minielectrodes (ME) on the catheter tip with closer interelectrode spacing was introduced. The aim of our study was to evaluate the novel electrodes during PVI. Methods PVI was performed with an irrigated ablation catheter equipped with conventional electrodes and three additional radial tip electrodes. Detection of pulmonary vein potentials (PVPs), local signal amplitude, amplitude reduction during ablation, and loss of capture after ablation were compared between the ME and the conventional tip‐ring electrodes. Results Thirty‐one patients (mean age 67.8 ± 10.3 years, 45.2 % men) were included. A total of 306 mapping/lesion points were analyzed. A PVP was significantly more often obtained with the ME compared to the conventional tip‐ring electrodes (99.2% vs 83.5%, P < 0.001). Local amplitude was significantly higher on the ME (0.8 ± 0.6 mV vs 0.67 ± 0.46 mV, P = 0.003). Amplitude reduction during 1 RF pulse was significantly greater on the ME (82.9 ± 19.5% vs. 61.8 ± 26.9%, P < 0.001). During pace mapping, loss of capture after 1 RF pulse was observed significantly more often on ME (98.3% vs 63.3%, P < 0.001). Conclusion Signal amplitude is higher and sensitivity during PVP mapping and ablation is increased when ME are used. ME may facilitate catheter ablation of AF in the future.