First data on cardiac mapping and outcome of pulmonary vein isolation using a novel ablation catheter with tip mini electrodes.

Aims: Pulmonary vein isolation (PVI) is a standard treatment of atrial fibrillation (AF). AF recurrence after PVI occurs in a substantial number of cases. A novel ablation catheter equipped with mini-electrodes (ME) may facilitate PVI. Our study evaluated outcome after PVI with the ME catheter compared to a standard catheter.

Methods: Patients undergoing PVI with the ME catheter were compared to a control group ablated with a standard contact force sensing catheter. Freedom of AF after 12 months was the study endpoint. Additionally, low voltage areas (LVA) <0.5 mV were identified with a circular mapping catheter (CMC) and the ablation catheter in each group. LVA were compared between the maps obtained with the CMC and the ME or standard catheter, respectively.

Results: A total of 110 patients underwent PVI with ME catheter (n = 59) or the standard catheter (n = 51). Procedure duration (117.4 ± 43 vs. 103.1 ± 32.8 min, p = 0.15), radiation dose (1135.6 ± 1125.7 vs. 1078.8 ± 951.4 μGy/m, p = 0.91), incidence of complications and 12-month success rate (64.4 vs 72.5%, p = 0.36) were not significantly different between the groups. LVA were significantly smaller when obtained with the standard catheter compared to the CMC (14 ± 13 vs. 58.5 ± 22.1 cm, p < 0.001), while no such difference was seen for mapping with the ME compared to the CMC (37 ± 30.3 vs. 33.4 ± 39 cm, p = 0.4).

Conclusion: Clinical outcomes are comparable between ME catheter and a standard contact force sensing catheter. Furthermore, better LVA detection points to improved mapping capabilities of the ME catheter.