Single-catheter approach to pulmonary vein reisolation in selected patients : Data from a prospective registry.

Background: In addition to different types of single-tip ablation catheters for pulmonary vein (PV) reisolation, a newly developed circular mapping and ablation catheter (nMARQ) has been available since 2013 and is currently used only in initial PV isolation procedures. In this prospective registry we present feasibility and efficacy data for PV reisolation procedures with a single-catheter approach (nMARQ) compared with a standard approach using a single-tip ablation catheter and a circular mapping catheter.

Methods: We included 35 carefully selected patients in this prospective registry and assigned them in a 2:1 ratio to undergo either PV reisolation with a single-tip ablation catheter together with a steerable circular mapping catheter (group 1) or with the nMARQcatheter only (group 2). The recurrence rate was calculated for atrial tachyarrhythmias with a duration of > 30 s during a mean follow-up of 12.7 months.

Results: Reisolation of all PVs was achieved in all patients of both groups. In group 2, all gaps could be correctly identified with the nMARQ catheter. PV isolation was clearly visible on the nMARQ catheter in all targeted veins. With the nMARQ catheter the ablation time decreased significantly (6.3 ± 3.0 vs. 18.6 ± 13.9 min, p < 0.05). The recurrence rate of atrial fibrillation did not differ significantly between the two groups (37.5 vs. 45.5 %, p = 0.66).

Conclusion: In selected patients, a complete PV reisolation procedure is feasible with a singular circular mapping and ablation catheter. The 12-months success rate is comparable to a classic approach with a combination of a single-tip ablation catheter and a circular mapping catheter.