Effect of Different Ablation Settings on Acute Complications Using the Novel Irrigated Multipolar Radiofrequency Ablation Catheter (nMARQ). (1st September 2015)

• Record Type: Journal Article
• Authors: DENEKE, THOMAS; MÜLLER, PATRICK; HALBFAß, PHILIPP; SZÖLLÖSI, ATILLA; ROOS, MARKUS; KRUG, JOACHIM; FOCHLER, FRANZISKA; SCHADE, ANJA; SCHMITT, RAINER; CHRISTOPOULOS, GEORGIOS; MÜGGE, ANDREAS; NENTWICH, KARIN
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 26:Number 10(2015:Oct.)
• Page Start: 1063
• Page End: 1068
• Publication Date: 2015-09-01
• Subjects: Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.12736
• Languages: English
• ISSNs: 1045-3873

Abstract

<abstract abstract-type="main"> <title>Effects of Different Energy Settings in nMARQ Ablation</title> <sec id="jce12736-sec-0010" sec-type="section"> <title>Background</title> <p>Single‐shot ablation devices for pulmonary vein isolation (PVI) in patients with symptomatic atrial fibrillation (AF) have been increasingly used in clinical practice.</p> </sec> <sec id="jce12736-sec-0020" sec-type="section"> <title>Objective</title> <p>A novel mapping‐system integrated irrigated multipolar circular ablation catheter (nMARQ) has been introduced for PVI but data on larger patient cohorts on acute safety and efficacy are lacking.</p> </sec> <sec id="jce12736-sec-0030" sec-type="section"> <title>Methods</title> <p>A total of 145 consecutive patients undergoing AF ablation treated with the nMARQ underwent endoscopic evaluation of esophageal thermal damage (EDEL) and brain MRI for detection of silent cerebral events (SCE). During the course of our experience different modifications of the ablation strategy, including energy delivery at the left atrial posterior wall, were evaluated.</p> </sec> <sec id="jce12736-sec-0040" sec-type="section"> <title>Results</title> <p>Effective PVI was achieved in 99% of all PVs during a mean procedure‐duration of 115 (±36) minutes and ablation‐duration of 18 (±8) minutes. Acute major complications occurred in 3 patients (2.1%) and asymptomatic complications like SCE in 26% and EDEL in 21%. There was a significant reduction in EDEL when not using a thermal esophageal probe (0% vs. 28%, P < 0.0001). Ablation under oral anticoagulation led to lower SCE incidences compared to interrupted anticoagulation regimen (15% vs. 31%, P = 0.7). Out of 65 patients with completed 12‐month follow‐up, 43 (66%) were in stable sinus rhythm.</p> </sec> <sec id="jce12736-sec-0050" sec-type="section"> <title>Conclusions</title> <p>PVI using the nMARQ is safe and effective in patients with symptomatic AF. Not using an esophageal temperature probe during ablation has relevantly reduced the incidence of EDEL. Ablations under continued oral anticoagulation have reduced incidence of SCE. Further studies on long‐term efficacy are needed.</p> </sec> </abstract>