Matthew Wright acknowledges financial support from the Department of Health via the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre award to Guy's & St. Thomas’ NHS Foundation Trust in partnership With King's College London and King's College Hospital NHS Foundation Trust.
Initial Results of Efficacy of Left Linear Ablation Using a Novel Simultaneous Multielectrode Ablation Catheter
Article first published online: 15 JAN 2011
© 2011 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 22, Issue 7, pages 739–745, July 2011
How to Cite
MIYAZAKI, S., HOCINI, M., LINTON, N., JADIDI, A. S., NAULT, I., WRIGHT, M., FORCLAZ, A., RIVARD, L., LIU, X., SHAH, A., XHAET, O., DERVAL, N., SACHER, F., JAÏS, P. and HAÏSSAGUERRE, M. (2011), Initial Results of Efficacy of Left Linear Ablation Using a Novel Simultaneous Multielectrode Ablation Catheter. Journal of Cardiovascular Electrophysiology, 22: 739–745. doi: 10.1111/j.1540-8167.2010.01999.x
Other authors: No disclosures.
- Issue published online: 21 JUL 2011
- Article first published online: 15 JAN 2011
- Manuscript received 23 October 2010; Revised manuscript received 3 December 2010; Accepted for publication 7 December 2010.
- atrial fibrillation;
- catheter ablation;
- linear ablation;
- mitral isthmus;
- multielectrode catheter
LA Linear Ablation With Multielectrode Catheter. Introduction: Creating complete linear block with point-by-point ablation is challenging in the left atrium (LA). The purpose of this study was to evaluate the efficacy of LA linear ablation using a hexapolar linear multielectrode mapping/ablation catheter.
Methods and Results: Seventeen patients (age 57 ± 10, 14 male, 6 paroxysmal AF (PAF)) were studied and underwent linear ablation at the mitral isthmus (MI) and LA roof. Ablation was performed with 90 second, 60 °C applications of duty-cycled bipolar/unipolar radiofrequency in a 1:1 ratio simultaneously at all selected electrode pairs. The result could not be evaluated in 2 patients because AF persisted despite cardioversion. Roof line block was confirmed in 9 of 15 (60%) patients. The mean number of applications and the procedural time with and without block was 5.4 ± 2.4 and 4.5 ± 2.2 applications, and 15 ± 8 and 13 ± 7 minutes. MI block was confirmed in 4 of 15 (27%) patients. The mean number of RF applications with and without block was 5.3 ± 2.2 and 9.9 ± 4.4 applications, and the procedural time was 20 ± 9 and 27 ± 10 minutes, respectively. For patients with underlying persistent AF, power was lower than those with PAF but improved when ablation was performed in sinus rhythm. Char was observed in 2 cases; however, no procedure-related complications were observed.
Conclusions: In our initial experience, a linear multielectrode catheter using duty-cycled bipolar and unipolar RF energy was inferior to conventional single point irrigated ablation in achieving LA linear block. However, successful linear block was obtained within a short period of time, when it was achieved. (J Cardiovasc Electrophysiol, Vol. 22, pp. 739-745, July 2011)