One-year follow-up after pulmonary vein isolation using a single mesh catheter in patients with paroxysmal atrial fibrillation.

BACKGROUND

Catheter-based pulmonary vein (PV) isolation has emerged as established therapy for patients with paroxysmal atrial fibrillation (AF).

OBJECTIVE

The purpose of this study was to determine the results at 1-year follow-up after PV isolation was performed using a single novel multipolar catheter for mapping and ablation.

METHODS

Patients with paroxysmal AF were screened by cardiac computed tomography for anatomic suitability to undergo PV ablation with the Bard HD Mesh Ablator Catheter (MESH). PV isolation with the MESH was performed only in patients who matched the criteria of four clearly separated PVs with an ostial diameter of 15 to 25 mm.

RESULTS

PV isolation with the MESH was performed in 36 (55%) of 65 screened patients. In all 36 patients, all PVs could be mapped with the MESH. Electrical isolation could be achieved in 135 (96%) of 140 PVs that revealed PV potentials. One-year follow-up was completed for 35 patients; one patient was lost to follow-up. Ten (29%) patients reported to be symptom-free and had no AF during three 48-hour ECGs, whereas 25 (71%) patients suffered from AF recurrences. Reablation performed in 11 patients revealed reconnection of three PVs in 6 patients and four PVs in 5 patients.

CONCLUSION

The single-catheter approach using the MESH for mapping and ablation was associated with a high AF recurrence rate within the first year despite a high acute success rate. Thus, the minimalist complexity of the procedure must be balanced with the poor clinical success leading to a high number of second procedures.