Pulmonary vein isolation with a new multipolar irrigated radiofrequency ablation catheter: feasibility, efficacy and safety

Purpose: Simultaneous multipolar ablation catheters for pulmonary vein isolation (PVI) have been proposed in order to simplify the atrial fibrillation (AF) ablation procedure. A new multipolar circular open-irrigated radiofrequency ablation catheter (nMARQTM) combining both mapping and multi-ablation capability through open-irrigation design has recently been developed. Our study aims to assess the feasibility, the acute success and the safety of this new technology with a particular interest in the incidence of periprocedural silent cerebral lesions (SCL) in patients undergoing AF ablation. Methods: 29 patients (age 55±14 years) with paroxysmal AF underwent PVI using the nMARQTM catheter. PVI was confirmed by circular multipolar mapping catheter (Lasso). A cerebral magnetic resonance imaging (MRI) was performed before and after the procedure. Results: The ablation procedure with the nMARQTM was feasible in all the patients without the use of a steerable sheath. PVI was achieved in 98% (117/119) of pulmonary veins identified and in 96% (28/29) of patients treated. Mean procedural time was 128±50 min, while mean fluoroscopy time was 1.7±2 min. Mean total RF time was 15.3 min. Out of 29 procedures, no procedural complications, including SCL, occurred. Conclusions: In our experience, PVI with nMARQTM catheter was feasible with good acute success and safety profile. No procedural complications, including new SCL detected by post-ablation brain MRI, were reported.