Usefulness of intracardiac echocardiography during pulmonary vein isolation with the novel multipolar irrigated ablation catheter (nMARQTM)

• DOI: 10.1007/s10840-015-0026-0
• Publication Date: 2015-06-22T06:38:14Z
• Authors: Antonio Dello Russo; Gaetano Fassini; Michela Casella; Antonio Di Monaco; Stefania Riva; Valentina Romano; Massimo Moltrasio; Fabrizio Tundo; Giuseppe De Martino; Benedetta Majocchi; Vittoria Marino; Eleonora Russo; Francesca Pizzami...; Giuseppe Del Giorno; Gemma Pelargonio; Luigi Di Biase; Andrea Natale; Claudio Tondo
• Keywords: Male; Middle Aged; Electrocardiography; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Echocardiography; Pulmonary Veins; Fluoroscopy; Atrial Fibrillation; Catheter Ablation; Humans; Atrial fibrillation ablation; Intracardiac echocardiography; nMARQTM ablation catheter; Atrial Fibrillation; Catheter Ablation; Echocardiography; Electrocardiography; Female; Fluoroscopy; Humans; Male; Middle Aged; Pulmonary Veins; Treatment Outcome; Ultrasonography, Interventional; Cardiology and Cardiovascular Medicine; Physiology (medical); Medicine (all); Female; Ultrasonography, Interventional

Previous studies reported the usefulness of an irrigated circular radiofrequency ablation catheter (nMARQ(TM), Biosense Webster) for pulmonary vein isolation (PVI). We evaluated the role of intracardiac echocardiography (ICE) to optimize the manipulation of nMARQ(TM) catheter.Thirty-seven patients (pts), (mean age 55 ± 12 years; 28 males) were enrolled to perform PVI. All pts underwent PVI with the nMARQ(TM) catheter. In 20 pts (group 1), we utilized ICE to guide nMARQ(TM) catheter positioning at the PV ostia; in the other 17 pts (group 2), nMARQ(TM) catheter was positioned at the PV ostia guided by fluoroscopy and TissueConnect(TM) technology.Radiofrequency (RF) applications were significantly lower in group 1 compared to group 2 [left PVs: 6 (range 3 to 12) in group 1 and 12 (range 5 to 16) in group 2 (p < 0.001); right PVs: 7 (range 4 to 14) in group 1 and 10 (range 5 to 16) in group 2 (p = 0.04)]; similarly regarding the time of RF delivery [left PVs: 318 ± 194 s in group 1 vs. 542 ± 104 s in group 2 (p < 0.001); right PVs: 410 ± 270 s in group 1 vs. 550 ± 156 s in group 2 (p = 0.05)]. Fluoroscopy time (23 ± 9 min vs. 28 ± 5 min; p = 0.05), procedural time (83 ± 23 min vs. 160 ± 42 min; p < 0.001), and radiation dose (109 ± 20 Gy/cm(2) vs. 127 ± 29 Gy/cm(2); p = 0.04) were significantly lower in group 1 compared to group 2.ICE might be a useful tool to guide nMARQ(TM) catheter position in the left atrium during atrial fibrillation (AF) ablation procedures.