Pulmonary vein isolation during cryoballoon ablation using the novel Achieve inner lumen mapping catheter: A feasibility study

Abstract

AimsCryoballoon (CB) ablation has proven very effective in achieving pulmonary vein isolation (PVI). The Achieve catheter (AC) is a novel inner lumen catheter designed to be used in conjunction with the CB, which serves the double purpose of a guidewire and a mapping catheter. We aimed to evaluate the feasibility of CB ablation in conjunction with the novel AC, in terms of PVI and safety in a series of patients affected by drug resistant paroxysmal atrial fibrillation (AF).Methods and resultsSeventy patients (49 male) affected by paroxysmal AF were assigned to CB PVI using the AC as a mapping catheter. Patients underwent loop-Holter monitoring 1, 3 and 6 months after ablation. Isolation occurred in 98 of PVs with the CBAC association without having switching to a regular guidewire. Pulmonary vein isolation could be documented by real-time (RT) recordings in 47 (132) of veins. Time to isolation was significantly longer in PVs exhibiting early left atriumPV reconnection if compared with veins with sustained isolation (117 ± 25 s vs. 59 ± 25 s; P< 0,005). No serious complications occurred; four transient phrenic nerve palsies occurred all resolving completely before the end of the procedure.ConclusionCryoballoon ablation in conjunction with the novel AC is feasible, safe, and most importantly affords PVI in nearly all veins without having to switch to a regular guidewire. However, RT recordings could be documented in only 47 of pulmonary veins. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2012.2012 © Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2012.