Pulmonary vein isolation using a novel decapolar over-the-wire mapping and ablation catheter.

Recently, a novel radiofrequency (RF) ablation system has been developed to perform pulmonary vein (PV) isolation. The system consists of a decapolar, steerable, over-the-wire mapping and ablation catheter combined with a multichannel RF generator that delivers energy in a temperature-controlled, power-limited fashion in both uni- and bi-polar modes. Using this technique, long continuous ablation lesions can be created within the left atrial antrum around the PV ostium. Electrical disconnection of PVs can be achieved in 93% of targeted PVs. Medium-term success is reported as 79.5% of patients with paroxysmal atrial fibrillation (no atrial fibrillation episodes detected during intensive holter monitoring). Ablation procedures using the novel technique are reported to be short (mean procedure duration: 84-201 min), including RF application duration of up to 40 min. Procedure-related complications are rare (1.8%) but the included total patient numbers are small and further studies on larger patient populations are needed.