Comparison of PV signal quality using a novel circular mapping and ablation catheter versus a standard circular mapping catheter

von Bary, Christian and Fredersdorf-Hahn, Sabine and Heinicke, Norbert and Jungbauer, Carsten and Schmid, Peter and Riegger, Guenter A. and Weber, Stefan (2011) Comparison of PV signal quality using a novel circular mapping and ablation catheter versus a standard circular mapping catheter. JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 31 (2). pp. 131-139. ISSN 1383-875X,

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Abstract

Purpose Recently, new catheter technologies have been developed for atrial fibrillation (AF) ablation. We investigate the diagnostic accuracy of a circular mapping and pulmonary vein ablation catheter (PVAC) compared with a standard circular mapping catheter (Orbiter) and the influence of filter settings on signal quality. Methods After reconstruction of the left atrium by three-dimensional atriography, baseline PV potentials (PVP) were recorded consecutively with PVAC and Orbiter in 20 patients with paroxysmal AF. PVPs were compared and attributed to predefined anatomical PV segments. Ablation was performed in 80 PVs using the PVAC. If isolation of the PVs was assumed, signal assessment of each PV was repeated with the Orbiter. If residual PV potentials could be uncovered, different filter settings were tested to improve mapping quality of the PVAC. Ablation was continued until complete PV isolation (PVI) was confirmed with the Orbiter. Results Baseline mapping demonstrated a good correlation between the Orbiter and PVAC. Mapping accuracy using the PVAC for mapping and ablation was 94% (74 of 79 PVs). Additional mapping with the Orbiter improved the PV isolation rate to 99%. Adjustment of filter settings failed to improve quality of the PV signals compared with standard filter settings. Conclusions Using the PVAC as a stand-alone strategy for mapping and ablation, one should be aware that in some cases, different signal morphology mimics PVI isolation. Adjustment of filter settings failed to improve signal quality. The use of an additional mapping catheter is recommended to become familiar with the particular signal morphology during the first PVAC cases or whenever there is a doubt about successful isolation of the pulmonary veins.

Item Type: Article
Uncontrolled Keywords: PERSISTENT ATRIAL-FIBRILLATION; PULMONARY VEIN ISOLATION; DOUBLE-LASSO TECHNIQUE; RADIOFREQUENCY ENERGY; GENERATOR; INSIGHTS; POINT; Atrial fibrillation; Pulmonary vein isolation; Ablation; Signal quality; Pulmonary vein ablation catheter
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin II
Depositing User: Dr. Gernot Deinzer
Date Deposited: 05 Jun 2020 04:28
Last Modified: 05 Jun 2020 04:28
URI: https://pred.uni-regensburg.de/id/eprint/20471

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