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Feng XF, Chen M, Sun J, Sun J, Liang B, Sun YY, Li YG. Development, safety and efficacy of a novel circular-irrigated deca-channel mapping and ablation catheter for pulmonary vein isolation. BMC Cardiovasc Disord 2018; 18:168. [PMID: 30111281 PMCID: PMC6094917 DOI: 10.1186/s12872-018-0886-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 07/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pulmonary vein isolation (PVI), a cornerstone for catheter ablation of atrial fibrillation (AF), remains a complex and time-consuming procedure. Present study introduces a novel, circular-irrigated, deca-channel mapping and ablation catheter (CIDMA), describes the in vitro test results on feasibility, safety, and acute efficacy of the CIDMA catheter. METHODS An assembled CIDMA catheter was subjected to a number of in vitro tests. With this catheter, ablation procedures were first performed in a pig's myocardial strips in vitro to determine the effects in unipolar or bipolar configuration. RESULTS Three catheters were assembled. The adjustable circular diameter was changed from initial state of 32.41 ± 0.61 mm into controlled state of 28.61 ± 0.47 mm (P = 0.013). In the plastic model, the push-ability, torque-ability, and kink resistance of CIDMA catheter were shown to be satisfactory. In vitro, our findings showed that ablation could produce obvious ablation lesions, and unipolar ablation (at length, width and depth of 5.0 ± 1.3, 4.6 ± 0.7, and 4.2 ± 0.6 mm, respectively) was more effective than bipolar (at length, width and depth of 2.8 ± 0.2, 4.2 ± 0.5, and 2.3 ± 0.4 mm, respectively) (P < 0.01). CONCLUSIONS In vitro, our preliminary data suggest that the CIDMA catheter produced optimal ablation lesions, especially in the unipolar ablation mode. Future in vivo animal and clinical studies are warranted to test the efficacy of this catheter in real-world scenario.
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Affiliation(s)
- Xiang-Fei Feng
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665#, KongJiang Road, Shanghai, 200092, China
| | - Mu Chen
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665#, KongJiang Road, Shanghai, 200092, China
| | - Jian Sun
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665#, KongJiang Road, Shanghai, 200092, China
| | - Jie Sun
- Shanghai MicroPort EP MedTech Co., Ltd, Building #28, Lane 588, Tianxiong Road, Shanghai, China
| | - Bo Liang
- Shanghai MicroPort EP MedTech Co., Ltd, Building #28, Lane 588, Tianxiong Road, Shanghai, China
| | - Yi-Yong Sun
- Shanghai MicroPort EP MedTech Co., Ltd, Building #28, Lane 588, Tianxiong Road, Shanghai, China
| | - Yi-Gang Li
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665#, KongJiang Road, Shanghai, 200092, China.
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Shin DI, Guelker JE, Blockhaus C, Schmidt J, Kurt M, Clasen L, Mueller P, Bansemir L, Brinkmeyer C, Bufe A, Kelm M, Makimoto H. One-Year Success Rate of Pulmonary Vein Isolation Using a Novel Irrigated Multipolar Mapping and Ablation Catheter With Reduced Power Settings. Int Heart J 2017; 58:205-210. [PMID: 28321025 DOI: 10.1536/ihj.16-254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The use of a novel irrigated multipolar ablation and mapping catheter for pulmonary vein isolation in patients with atrial fibrillation (AF) has demonstrated reasonable acute success rates and short procedure times, however, long-term outcome data are limited. The aim of this study was to analyze the long-term efficacy of this novel ablation system utilizing a reduced power setting for safety purposes.A total of 89 patients with paroxysmal (63 of 89 patients; 71%) or persistent AF underwent PVI with a reduced power setting of maximum 20 Watts (W) unipolar radiofrequency energy and 30 seconds in duration. In cases of persistent AF, atrial substrate ablation was performed additionally. Follow-up was based on outpatient clinic visits at 3, 6, and 12 months and included 5-day Holter ECGs. All of the 347 identified pulmonary veins were successfully isolated. Mean procedure times in PVI and PVI plus substrate ablation were 102 ± 25 minutes and 126 ± 32 minutes, respectively, applying a mean total radiofrequency time of 14 ± 6 minutes and 19 ± 9 minutes. Mean fluoroscopy time was 17 ± 8 minutes and 18 ± 6 minutes, respectively. Follow-up was available for all 89 patients. At one-year follow-up, 44 (70%) patients with paroxysmal AF and 11 (42%) patients with persistent AF remained in stable sinus rhythm after a singleprocedure and off antiarrhythmic drugs.The use of a novel irrigated multipolar ablation catheter with a reduced power setting is safe and feasible, and demonstrates a one-year success rate of 70% in paroxysmal AF and 42% in persistent AF.
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Affiliation(s)
- Dong-In Shin
- Heart Centre Niederrhein, Department of Cardiology, Helios Clinics Krefeld
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Shin DI, Kirmanoglou K, Eickholt C, Schmidt J, Clasen L, Butzbach B, Rassaf T, Merx M, Kelm M, Meyer C. Initial results of using a novel irrigated multielectrode mapping and ablation catheter for pulmonary vein isolation. Heart Rhythm 2013; 11:375-83. [PMID: 24321239 DOI: 10.1016/j.hrthm.2013.12.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pulmonary vein isolation (PVI) as a cornerstone for catheter ablation of atrial fibrillation (AF) remains a complex and time-consuming procedure. OBJECTIVE To assess feasibility, safety, and acute efficacy of a novel irrigated multielectrode ablation catheter guided by an electroanatomic mapping system for PVI in patients with paroxysmal AF. METHODS Twenty-five consecutive patients (60 ± 10 years) with paroxysmal AF underwent PVI by using a novel decapolar mapping and ablation catheter (nMARQ catheter, Biosense Webster Inc, Diamond Bar, CA). Ablation was guided by electroanatomic mapping allowing radiofrequency (RF) energy delivery in the antral region of pulmonary veins (PVs) from 10 irrigated electrodes simultaneously. The day after ablation, cardiac magnetic resonance imaging was performed routinely in order to assess for potential acute PV stenosis. RESULTS Overall, 97 of 97 (100%) targeted PVs could be isolated with a mean of 27 ± 11 RF applications and a mean total burning time of 15 ± 6 minutes per patient. The total procedure time from femoral vein access to catheter withdrawal was 110 ± 31 minutes, including a mean total fluoroscopy time of 23 ± 9 minutes. On average, 6 ± 3 RF impulses with a maximum of 25 W were applied per vein. After a short learning curve, procedure, fluoroscopy, and total burning times decreased to 94 ± 16, 16 ± 3, and 9 ± 2 minutes, respectively (P < .05). Entrance and exit blocks could be verified by placing the ablation catheter into 90 of 97 (93%) PVs in 18 of 25 (72%) patients. No procedure-related complications were observed, especially no acute PV stenosis could be detected. CONCLUSIONS The use of a novel irrigated multielectrode ablation system for PVI is feasible and safe, resulting in acute isolation of all targeted PVs with no complications and short procedure times. Sustainability of these initial results has to be confirmed in long-term efficacy and follow-up trials.
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Affiliation(s)
- Dong-In Shin
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany.
| | - Kiriakos Kirmanoglou
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany
| | - Christian Eickholt
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany
| | - Jan Schmidt
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany
| | - Lukas Clasen
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany
| | - Britta Butzbach
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany
| | - Tienush Rassaf
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany
| | - Marc Merx
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany
| | - Malte Kelm
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany
| | - Christian Meyer
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital, Duesseldorf, Germany
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von BARY CHRISTIAN, DORNIA CHRISTIAN, KIRCHNER GABRIELE, WEBER STEFAN, FELLNER CLAUDIA, NISENBAUM DAVID, GEORGIEVA MARTINA, STROSZCZYNSKI CHRISTIAN, HAMER OKKAW. Esophageal Tissue Injury Following Pulmonary Vein Isolation Using the PVAC: Assessment by Endoscopy and Magnetic Resonance Imaging. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2013; 36:477-85. [DOI: 10.1111/pace.12085] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 10/27/2012] [Accepted: 11/24/2012] [Indexed: 12/20/2022]
Affiliation(s)
| | | | - GABRIELE KIRCHNER
- Klinik und Poliklinik für Innere Medizin I; University Medical Center Regensburg; Regensburg; Germany
| | - STEFAN WEBER
- Klinik und Poliklinik für Innere Medizin II; University Medical Center Regensburg; Regensburg; Germany
| | | | - DAVID NISENBAUM
- Klinik und Poliklinik für Innere Medizin II; University Medical Center Regensburg; Regensburg; Germany
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Deneke T, Mügge A, Balta O, Horlitz M, Grewe PH, Shin DI. Treatment of persistent atrial fibrillation using phased radiofrequency ablation technology. Expert Rev Cardiovasc Ther 2012; 9:1041-9. [PMID: 21878048 DOI: 10.1586/erc.11.110] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A novel ablation system consisting of a duty-cycled phased radiofrequency generator and multielectrode mapping and ablation catheters has been introduced to provide ablation therapy in patients with symptomatic atrial fibrillation (AF). Contiguous lesions may be created using anatomically designed ablation catheters maneuvered under fluoroscopic guidance without the use of a 3D electroanatomic mapping system. In addition to pulmonary vein isolation using a circular, decapolar ablation catheter, an ablation strategy targeting complex fractionated atrial electrograms can be performed using two supplemental multiarray catheters specifically designed for ablation at the left atrial septum and within the left atrial body. Procedural times for treating persistent AF using phased radiofrequency are reported as being between 2 and 2.5 h. Freedom from AF ranges between 33 and 75% after a single procedure, which is comparable to other conventional ablation approaches (utilizing electroanatomic mapping). Additional studies in larger patient numbers are needed to understand the long-term maintenance of results and potential adverse effects of the technology.
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Affiliation(s)
- Thomas Deneke
- Academic Heart Center Cologne-Porz, Urbacher Weg 19, Cologne, Germany.
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Predictive value of left atrial volume measured by non-invasive cardiac imaging in the treatment of paroxysmal atrial fibrillation. J Interv Card Electrophysiol 2012; 34:181-8. [DOI: 10.1007/s10840-011-9641-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Accepted: 11/02/2011] [Indexed: 10/14/2022]
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von Bary C, Weber S, Dornia C, Eissnert C, Fellner C, Latzin P, Fredersdorf S, Stadler S, Hamer OW. Evaluation of Pulmonary Vein Stenosis After Pulmonary Vein Isolation Using a Novel Circular Mapping and Ablation Catheter (PVAC). Circ Arrhythm Electrophysiol 2011; 4:630-6. [DOI: 10.1161/circep.111.963397] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Christian von Bary
- From the Klinik und Poliklinik für Innere Medizin II (C.v.B., S.W., C.E., S.F., S.S.) and Institut für Röntgendiagnostik (C.D., C.F., O.W.H.), University Medical Center Regensburg, Regensburg, Germany; and Division of Respiratory Medicine, Inselspital, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (P.L.)
| | - Stefan Weber
- From the Klinik und Poliklinik für Innere Medizin II (C.v.B., S.W., C.E., S.F., S.S.) and Institut für Röntgendiagnostik (C.D., C.F., O.W.H.), University Medical Center Regensburg, Regensburg, Germany; and Division of Respiratory Medicine, Inselspital, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (P.L.)
| | - Christian Dornia
- From the Klinik und Poliklinik für Innere Medizin II (C.v.B., S.W., C.E., S.F., S.S.) and Institut für Röntgendiagnostik (C.D., C.F., O.W.H.), University Medical Center Regensburg, Regensburg, Germany; and Division of Respiratory Medicine, Inselspital, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (P.L.)
| | - Christoph Eissnert
- From the Klinik und Poliklinik für Innere Medizin II (C.v.B., S.W., C.E., S.F., S.S.) and Institut für Röntgendiagnostik (C.D., C.F., O.W.H.), University Medical Center Regensburg, Regensburg, Germany; and Division of Respiratory Medicine, Inselspital, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (P.L.)
| | - Claudia Fellner
- From the Klinik und Poliklinik für Innere Medizin II (C.v.B., S.W., C.E., S.F., S.S.) and Institut für Röntgendiagnostik (C.D., C.F., O.W.H.), University Medical Center Regensburg, Regensburg, Germany; and Division of Respiratory Medicine, Inselspital, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (P.L.)
| | - Philipp Latzin
- From the Klinik und Poliklinik für Innere Medizin II (C.v.B., S.W., C.E., S.F., S.S.) and Institut für Röntgendiagnostik (C.D., C.F., O.W.H.), University Medical Center Regensburg, Regensburg, Germany; and Division of Respiratory Medicine, Inselspital, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (P.L.)
| | - Sabine Fredersdorf
- From the Klinik und Poliklinik für Innere Medizin II (C.v.B., S.W., C.E., S.F., S.S.) and Institut für Röntgendiagnostik (C.D., C.F., O.W.H.), University Medical Center Regensburg, Regensburg, Germany; and Division of Respiratory Medicine, Inselspital, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (P.L.)
| | - Stefan Stadler
- From the Klinik und Poliklinik für Innere Medizin II (C.v.B., S.W., C.E., S.F., S.S.) and Institut für Röntgendiagnostik (C.D., C.F., O.W.H.), University Medical Center Regensburg, Regensburg, Germany; and Division of Respiratory Medicine, Inselspital, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (P.L.)
| | - Okka W. Hamer
- From the Klinik und Poliklinik für Innere Medizin II (C.v.B., S.W., C.E., S.F., S.S.) and Institut für Röntgendiagnostik (C.D., C.F., O.W.H.), University Medical Center Regensburg, Regensburg, Germany; and Division of Respiratory Medicine, Inselspital, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (P.L.)
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von Bary C, Fredersdorf-Hahn S, Heinicke N, Jungbauer C, Schmid P, Riegger GA, Weber S. Comparison of PV signal quality using a novel circular mapping and ablation catheter versus a standard circular mapping catheter. J Interv Card Electrophysiol 2011; 31:131-9. [DOI: 10.1007/s10840-011-9546-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 01/17/2011] [Indexed: 10/18/2022]
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DENEKE THOMAS, BÜNZ KATHRIN, BASTIAN ANNELY, PÄSLER MARCUS, ANDERS HELGE, LEHMANN RAINER, MEUSER WOLFGANG, DE GROOT JORISR, HORLITZ MARC, HABERKORN RON, MÜGGE ANDREAS, SHIN DONGIN. Utility of Esophageal Temperature Monitoring During Pulmonary Vein Isolation for Atrial Fibrillation Using Duty-Cycled Phased Radiofrequency Ablation. J Cardiovasc Electrophysiol 2010; 22:255-61. [DOI: 10.1111/j.1540-8167.2010.01916.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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