A novel mesh electrode catheter for mapping and radiofrequency delivery at the left atrium-pulmonary vein junction: A single-catheter approach to pulmonary vein antrum isolation

Mauricio S. Arruda, Ding Sheng He, Paul Andrew Friedman, Hiroshi Nakagawa, Charles J Bruce, Koji Azegami, Robert Anders, Peter Kozel, Amedeo Chiavetta, Paul Marad, David MacAdam, Warren Jackman, David J. Wilber

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

A Single-Catheter for Mapping and Ablation of PV. Background: Electrical isolation of pulmonary veins (PV) by radiofrequency (RF) ablation is often performed in patients with atrial fibrillation (AF). Current catheter technology usually requires the use of a multielectrode catheter for mapping in addition to the ablation catheter. Purpose: We evaluated the feasibility and safety of using a single, expandable electrode catheter (MESH) to map and to electrically isolate the PV. Methods and Results: Nineteen closed-chest mongrel dogs, weighing 23-35 kg, were studied under general anesthesia. Intracardiac echocardiography (ICE) was used to guide transseptal puncture and to assess PV dimensions and contact of the MESH with PV ostia. ICE and angiography of RSPV were obtained before and after ablation, and prior to sacrifice at 7-99 days. An 11.5 Fr steerable MESH was advanced and deployed at the ostium of the RSPV. Recordings were obtained via the 36 electrodes comprising the MESH. For circumferential ablation, RF current was delivered at a target temperature of 62-65°C (4 thermocouples) and maximum power of 70-100 W for 180 to 300 seconds. Each animal received 1-4 RF applications. Entrance conduction block was obtained in 13/19 treated RSPVs. Pathological examination confirmed circumferential and transmural lesions in 13 of 19 RSPV. LA mural thrombus was present in 3 animals. There was no significant PV stenosis. Conclusion: Based on this canine model, a new expandable MESH catheter may safely be used for mapping and for PV antrum isolation. This approach may decrease procedure time without compromising success rate in patients undergoing AF ablation.

Original languageEnglish (US)
Pages (from-to)206-211
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume18
Issue number2
DOIs
StatePublished - Feb 2007

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Pulmonary Veins
Heart Atria
Electrodes
Catheters
Catheter Ablation
Atrial Fibrillation
Echocardiography
Punctures
General Anesthesia
Canidae
Angiography
Thrombosis
Thorax
Dogs
Technology
Safety
Temperature

Keywords

  • AF ablation
  • Atrial fibrillation
  • Catheter Ablation
  • Multi electrode catheter
  • Pulmonary vein

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

A novel mesh electrode catheter for mapping and radiofrequency delivery at the left atrium-pulmonary vein junction : A single-catheter approach to pulmonary vein antrum isolation. / Arruda, Mauricio S.; He, Ding Sheng; Friedman, Paul Andrew; Nakagawa, Hiroshi; Bruce, Charles J; Azegami, Koji; Anders, Robert; Kozel, Peter; Chiavetta, Amedeo; Marad, Paul; MacAdam, David; Jackman, Warren; Wilber, David J.

In: Journal of Cardiovascular Electrophysiology, Vol. 18, No. 2, 02.2007, p. 206-211.

Research output: Contribution to journalArticle

Arruda, Mauricio S. ; He, Ding Sheng ; Friedman, Paul Andrew ; Nakagawa, Hiroshi ; Bruce, Charles J ; Azegami, Koji ; Anders, Robert ; Kozel, Peter ; Chiavetta, Amedeo ; Marad, Paul ; MacAdam, David ; Jackman, Warren ; Wilber, David J. / A novel mesh electrode catheter for mapping and radiofrequency delivery at the left atrium-pulmonary vein junction : A single-catheter approach to pulmonary vein antrum isolation. In: Journal of Cardiovascular Electrophysiology. 2007 ; Vol. 18, No. 2. pp. 206-211.
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abstract = "A Single-Catheter for Mapping and Ablation of PV. Background: Electrical isolation of pulmonary veins (PV) by radiofrequency (RF) ablation is often performed in patients with atrial fibrillation (AF). Current catheter technology usually requires the use of a multielectrode catheter for mapping in addition to the ablation catheter. Purpose: We evaluated the feasibility and safety of using a single, expandable electrode catheter (MESH) to map and to electrically isolate the PV. Methods and Results: Nineteen closed-chest mongrel dogs, weighing 23-35 kg, were studied under general anesthesia. Intracardiac echocardiography (ICE) was used to guide transseptal puncture and to assess PV dimensions and contact of the MESH with PV ostia. ICE and angiography of RSPV were obtained before and after ablation, and prior to sacrifice at 7-99 days. An 11.5 Fr steerable MESH was advanced and deployed at the ostium of the RSPV. Recordings were obtained via the 36 electrodes comprising the MESH. For circumferential ablation, RF current was delivered at a target temperature of 62-65°C (4 thermocouples) and maximum power of 70-100 W for 180 to 300 seconds. Each animal received 1-4 RF applications. Entrance conduction block was obtained in 13/19 treated RSPVs. Pathological examination confirmed circumferential and transmural lesions in 13 of 19 RSPV. LA mural thrombus was present in 3 animals. There was no significant PV stenosis. Conclusion: Based on this canine model, a new expandable MESH catheter may safely be used for mapping and for PV antrum isolation. This approach may decrease procedure time without compromising success rate in patients undergoing AF ablation.",
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T2 - A single-catheter approach to pulmonary vein antrum isolation

AU - Arruda, Mauricio S.

AU - He, Ding Sheng

AU - Friedman, Paul Andrew

AU - Nakagawa, Hiroshi

AU - Bruce, Charles J

AU - Azegami, Koji

AU - Anders, Robert

AU - Kozel, Peter

AU - Chiavetta, Amedeo

AU - Marad, Paul

AU - MacAdam, David

AU - Jackman, Warren

AU - Wilber, David J.

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N2 - A Single-Catheter for Mapping and Ablation of PV. Background: Electrical isolation of pulmonary veins (PV) by radiofrequency (RF) ablation is often performed in patients with atrial fibrillation (AF). Current catheter technology usually requires the use of a multielectrode catheter for mapping in addition to the ablation catheter. Purpose: We evaluated the feasibility and safety of using a single, expandable electrode catheter (MESH) to map and to electrically isolate the PV. Methods and Results: Nineteen closed-chest mongrel dogs, weighing 23-35 kg, were studied under general anesthesia. Intracardiac echocardiography (ICE) was used to guide transseptal puncture and to assess PV dimensions and contact of the MESH with PV ostia. ICE and angiography of RSPV were obtained before and after ablation, and prior to sacrifice at 7-99 days. An 11.5 Fr steerable MESH was advanced and deployed at the ostium of the RSPV. Recordings were obtained via the 36 electrodes comprising the MESH. For circumferential ablation, RF current was delivered at a target temperature of 62-65°C (4 thermocouples) and maximum power of 70-100 W for 180 to 300 seconds. Each animal received 1-4 RF applications. Entrance conduction block was obtained in 13/19 treated RSPVs. Pathological examination confirmed circumferential and transmural lesions in 13 of 19 RSPV. LA mural thrombus was present in 3 animals. There was no significant PV stenosis. Conclusion: Based on this canine model, a new expandable MESH catheter may safely be used for mapping and for PV antrum isolation. This approach may decrease procedure time without compromising success rate in patients undergoing AF ablation.

AB - A Single-Catheter for Mapping and Ablation of PV. Background: Electrical isolation of pulmonary veins (PV) by radiofrequency (RF) ablation is often performed in patients with atrial fibrillation (AF). Current catheter technology usually requires the use of a multielectrode catheter for mapping in addition to the ablation catheter. Purpose: We evaluated the feasibility and safety of using a single, expandable electrode catheter (MESH) to map and to electrically isolate the PV. Methods and Results: Nineteen closed-chest mongrel dogs, weighing 23-35 kg, were studied under general anesthesia. Intracardiac echocardiography (ICE) was used to guide transseptal puncture and to assess PV dimensions and contact of the MESH with PV ostia. ICE and angiography of RSPV were obtained before and after ablation, and prior to sacrifice at 7-99 days. An 11.5 Fr steerable MESH was advanced and deployed at the ostium of the RSPV. Recordings were obtained via the 36 electrodes comprising the MESH. For circumferential ablation, RF current was delivered at a target temperature of 62-65°C (4 thermocouples) and maximum power of 70-100 W for 180 to 300 seconds. Each animal received 1-4 RF applications. Entrance conduction block was obtained in 13/19 treated RSPVs. Pathological examination confirmed circumferential and transmural lesions in 13 of 19 RSPV. LA mural thrombus was present in 3 animals. There was no significant PV stenosis. Conclusion: Based on this canine model, a new expandable MESH catheter may safely be used for mapping and for PV antrum isolation. This approach may decrease procedure time without compromising success rate in patients undergoing AF ablation.

KW - AF ablation

KW - Atrial fibrillation

KW - Catheter Ablation

KW - Multi electrode catheter

KW - Pulmonary vein

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