Safety, efficacy, and clinical applicability of pulmonary vein isolation with circular multi-electrode ablation systems: PVAC® vs. nMARQ™ for atrial fibrillation ablation
We compare our experience with available circular multi-electrode catheters for atrial fibrillation (AF) ablation: PVAC(®), a phased radiofrequency system, and nMARQ™, an irrigated tip-CARTO-based technology. Prospective observational study of 175 consecutive patients with follow-up duration of at l...
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| Veröffentlicht in: | Europace (London, England) England), 2016-06, Vol.18 (6), p.807-814 |
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| creator | Laish-Farkash, Avishag Khalameizer, Vladimir Fishman, Evgeny Cohen, Ornit Yosefy, Chaim Cohen, Iris Katz, Amos |
| description | We compare our experience with available circular multi-electrode catheters for atrial fibrillation (AF) ablation: PVAC(®), a phased radiofrequency system, and nMARQ™, an irrigated tip-CARTO-based technology.
Prospective observational study of 175 consecutive patients with follow-up duration of at least 5 months who underwent pulmonary vein isolation (PVI) for symptomatic AF using PVAC(®) (n = 93, age 61.4 ± 9.8 years; 60% male, 13% persistent AF) vs. nMARQ™ (n = 82, age 63.2 ± 10.6 years; 67% male, 24% persistent AF). Procedure and radiation times were 94 ± 27 and 33 ± 13 min for PVAC(®) and 81 ± 18 and 30 ± 8.5 for nMARQ™ (P = 0.0008 and P = 0.18), respectively. The number of applications and the total burning time (min) were 20 ± 7 and 19 ± 6.7 for PVAC(®) and 16 ± 5.6 and 11 ± 4 for nMARQ™ (P < 0.0001 for both), respectively. In two nMARQ™ patients with small atria and pulmonary veins (PVs) and in two PVAC(®) patients with large PVs, the procedure failed; switching to the alternative technology was successful. Acute success rate was 97% for PVAC(®) and 95% for nMARQ™. There was one tamponade in nMARQ™ group and non-significant different minor complications for both techniques. One-year freedom from AF was 79 and 80.7% with PVAC(®) vs. nMARQ™, after one PVI, and 88 vs. 87.7% after two PVIs.
Both technologies have short procedure and fluoroscopy times, comparable complication rates, and comparable acute and 1-year success rates. The number of applications and total procedure and burning times were shorter with nMARQ™. nMARQ™ was more suitable for larger atria and PVs. Thus, a patient-based pre-ablation anatomy definition is probably warranted for appropriate selection of technology type. |
| doi_str_mv | 10.1093/europace/euv258 |
| format | Article |
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Prospective observational study of 175 consecutive patients with follow-up duration of at least 5 months who underwent pulmonary vein isolation (PVI) for symptomatic AF using PVAC(®) (n = 93, age 61.4 ± 9.8 years; 60% male, 13% persistent AF) vs. nMARQ™ (n = 82, age 63.2 ± 10.6 years; 67% male, 24% persistent AF). Procedure and radiation times were 94 ± 27 and 33 ± 13 min for PVAC(®) and 81 ± 18 and 30 ± 8.5 for nMARQ™ (P = 0.0008 and P = 0.18), respectively. The number of applications and the total burning time (min) were 20 ± 7 and 19 ± 6.7 for PVAC(®) and 16 ± 5.6 and 11 ± 4 for nMARQ™ (P < 0.0001 for both), respectively. In two nMARQ™ patients with small atria and pulmonary veins (PVs) and in two PVAC(®) patients with large PVs, the procedure failed; switching to the alternative technology was successful. Acute success rate was 97% for PVAC(®) and 95% for nMARQ™. There was one tamponade in nMARQ™ group and non-significant different minor complications for both techniques. One-year freedom from AF was 79 and 80.7% with PVAC(®) vs. nMARQ™, after one PVI, and 88 vs. 87.7% after two PVIs.
Both technologies have short procedure and fluoroscopy times, comparable complication rates, and comparable acute and 1-year success rates. The number of applications and total procedure and burning times were shorter with nMARQ™. nMARQ™ was more suitable for larger atria and PVs. Thus, a patient-based pre-ablation anatomy definition is probably warranted for appropriate selection of technology type.</description><identifier>ISSN: 1099-5129</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/euv258</identifier><identifier>PMID: 26589623</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Atrial Fibrillation - surgery ; Catheter Ablation - instrumentation ; Electrodes, Implanted ; Equipment Design ; Equipment Failure Analysis ; Female ; Fluoroscopy ; Follow-Up Studies ; Heart Atria - surgery ; Humans ; Israel ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Veins - surgery ; Treatment Outcome</subject><ispartof>Europace (London, England), 2016-06, Vol.18 (6), p.807-814</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c338t-b1a2a255c5bbe2d741d9c50dbdbf066dcdafe2bee2d77df02189a84315ca10443</citedby><cites>FETCH-LOGICAL-c338t-b1a2a255c5bbe2d741d9c50dbdbf066dcdafe2bee2d77df02189a84315ca10443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26589623$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Laish-Farkash, Avishag</creatorcontrib><creatorcontrib>Khalameizer, Vladimir</creatorcontrib><creatorcontrib>Fishman, Evgeny</creatorcontrib><creatorcontrib>Cohen, Ornit</creatorcontrib><creatorcontrib>Yosefy, Chaim</creatorcontrib><creatorcontrib>Cohen, Iris</creatorcontrib><creatorcontrib>Katz, Amos</creatorcontrib><title>Safety, efficacy, and clinical applicability of pulmonary vein isolation with circular multi-electrode ablation systems: PVAC® vs. nMARQ™ for atrial fibrillation ablation</title><title>Europace (London, England)</title><addtitle>Europace</addtitle><description>We compare our experience with available circular multi-electrode catheters for atrial fibrillation (AF) ablation: PVAC(®), a phased radiofrequency system, and nMARQ™, an irrigated tip-CARTO-based technology.
Prospective observational study of 175 consecutive patients with follow-up duration of at least 5 months who underwent pulmonary vein isolation (PVI) for symptomatic AF using PVAC(®) (n = 93, age 61.4 ± 9.8 years; 60% male, 13% persistent AF) vs. nMARQ™ (n = 82, age 63.2 ± 10.6 years; 67% male, 24% persistent AF). Procedure and radiation times were 94 ± 27 and 33 ± 13 min for PVAC(®) and 81 ± 18 and 30 ± 8.5 for nMARQ™ (P = 0.0008 and P = 0.18), respectively. The number of applications and the total burning time (min) were 20 ± 7 and 19 ± 6.7 for PVAC(®) and 16 ± 5.6 and 11 ± 4 for nMARQ™ (P < 0.0001 for both), respectively. In two nMARQ™ patients with small atria and pulmonary veins (PVs) and in two PVAC(®) patients with large PVs, the procedure failed; switching to the alternative technology was successful. Acute success rate was 97% for PVAC(®) and 95% for nMARQ™. There was one tamponade in nMARQ™ group and non-significant different minor complications for both techniques. One-year freedom from AF was 79 and 80.7% with PVAC(®) vs. nMARQ™, after one PVI, and 88 vs. 87.7% after two PVIs.
Both technologies have short procedure and fluoroscopy times, comparable complication rates, and comparable acute and 1-year success rates. The number of applications and total procedure and burning times were shorter with nMARQ™. nMARQ™ was more suitable for larger atria and PVs. Thus, a patient-based pre-ablation anatomy definition is probably warranted for appropriate selection of technology type.</description><subject>Aged</subject><subject>Atrial Fibrillation - surgery</subject><subject>Catheter Ablation - instrumentation</subject><subject>Electrodes, Implanted</subject><subject>Equipment Design</subject><subject>Equipment Failure Analysis</subject><subject>Female</subject><subject>Fluoroscopy</subject><subject>Follow-Up Studies</subject><subject>Heart Atria - surgery</subject><subject>Humans</subject><subject>Israel</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Pulmonary Veins - surgery</subject><subject>Treatment Outcome</subject><issn>1099-5129</issn><issn>1532-2092</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9Uctu1DAUtRCIlrbr7pCXLEhrO-MkZjca8ZKKCvSxjfy4Vo2cONjOoNnzJd2Xj-BT-BJczUxX91zdc-7rIHRKyRkloj6HOYZJaihgzXj3DB1SXrOKEcGeF0yEqDhl4gC9SukHIaRlgr9EB6zhnWhYfYgerqSFvHmLwVqnpS5IjgZr78aSeiynyRegnHd5g4PF0-yHMMq4wWtwI3YpeJldGPEvl--wdlHPXkY8zD67CjzoHIMBLNWOljYpw5De4a-3y9XfP3idzvD4Zfn927_f99iGiGWOrgy2TkXnd6K9-hi9sNInONnFI3Tz4f316lN1cfnx82p5Uem67nKlqGSSca65UsBMu6BGaE6MMsqSpjHalKOZgsdaayxhtBOyW9SUa0nJYlEfoTfbvlMMP2dIuR9c0lDWGSHMqaetaBlvOKGFer6l6hhSimD7Kbqh_KenpH_0qN971G89KorXu-azGsA88fem1P8BzY6WtQ</recordid><startdate>201606</startdate><enddate>201606</enddate><creator>Laish-Farkash, Avishag</creator><creator>Khalameizer, Vladimir</creator><creator>Fishman, Evgeny</creator><creator>Cohen, Ornit</creator><creator>Yosefy, Chaim</creator><creator>Cohen, Iris</creator><creator>Katz, Amos</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201606</creationdate><title>Safety, efficacy, and clinical applicability of pulmonary vein isolation with circular multi-electrode ablation systems: PVAC® vs. nMARQ™ for atrial fibrillation ablation</title><author>Laish-Farkash, Avishag ; Khalameizer, Vladimir ; Fishman, Evgeny ; Cohen, Ornit ; Yosefy, Chaim ; Cohen, Iris ; Katz, Amos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c338t-b1a2a255c5bbe2d741d9c50dbdbf066dcdafe2bee2d77df02189a84315ca10443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Atrial Fibrillation - surgery</topic><topic>Catheter Ablation - instrumentation</topic><topic>Electrodes, Implanted</topic><topic>Equipment Design</topic><topic>Equipment Failure Analysis</topic><topic>Female</topic><topic>Fluoroscopy</topic><topic>Follow-Up Studies</topic><topic>Heart Atria - surgery</topic><topic>Humans</topic><topic>Israel</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Pulmonary Veins - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Laish-Farkash, Avishag</creatorcontrib><creatorcontrib>Khalameizer, Vladimir</creatorcontrib><creatorcontrib>Fishman, Evgeny</creatorcontrib><creatorcontrib>Cohen, Ornit</creatorcontrib><creatorcontrib>Yosefy, Chaim</creatorcontrib><creatorcontrib>Cohen, Iris</creatorcontrib><creatorcontrib>Katz, Amos</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Europace (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Laish-Farkash, Avishag</au><au>Khalameizer, Vladimir</au><au>Fishman, Evgeny</au><au>Cohen, Ornit</au><au>Yosefy, Chaim</au><au>Cohen, Iris</au><au>Katz, Amos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety, efficacy, and clinical applicability of pulmonary vein isolation with circular multi-electrode ablation systems: PVAC® vs. nMARQ™ for atrial fibrillation ablation</atitle><jtitle>Europace (London, England)</jtitle><addtitle>Europace</addtitle><date>2016-06</date><risdate>2016</risdate><volume>18</volume><issue>6</issue><spage>807</spage><epage>814</epage><pages>807-814</pages><issn>1099-5129</issn><eissn>1532-2092</eissn><abstract>We compare our experience with available circular multi-electrode catheters for atrial fibrillation (AF) ablation: PVAC(®), a phased radiofrequency system, and nMARQ™, an irrigated tip-CARTO-based technology.
Prospective observational study of 175 consecutive patients with follow-up duration of at least 5 months who underwent pulmonary vein isolation (PVI) for symptomatic AF using PVAC(®) (n = 93, age 61.4 ± 9.8 years; 60% male, 13% persistent AF) vs. nMARQ™ (n = 82, age 63.2 ± 10.6 years; 67% male, 24% persistent AF). Procedure and radiation times were 94 ± 27 and 33 ± 13 min for PVAC(®) and 81 ± 18 and 30 ± 8.5 for nMARQ™ (P = 0.0008 and P = 0.18), respectively. The number of applications and the total burning time (min) were 20 ± 7 and 19 ± 6.7 for PVAC(®) and 16 ± 5.6 and 11 ± 4 for nMARQ™ (P < 0.0001 for both), respectively. In two nMARQ™ patients with small atria and pulmonary veins (PVs) and in two PVAC(®) patients with large PVs, the procedure failed; switching to the alternative technology was successful. Acute success rate was 97% for PVAC(®) and 95% for nMARQ™. There was one tamponade in nMARQ™ group and non-significant different minor complications for both techniques. One-year freedom from AF was 79 and 80.7% with PVAC(®) vs. nMARQ™, after one PVI, and 88 vs. 87.7% after two PVIs.
Both technologies have short procedure and fluoroscopy times, comparable complication rates, and comparable acute and 1-year success rates. The number of applications and total procedure and burning times were shorter with nMARQ™. nMARQ™ was more suitable for larger atria and PVs. Thus, a patient-based pre-ablation anatomy definition is probably warranted for appropriate selection of technology type.</abstract><cop>England</cop><pmid>26589623</pmid><doi>10.1093/europace/euv258</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Europace (London, England), 2016-06, Vol.18 (6), p.807-814 |
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| source | MEDLINE; Oxford Journals Open Access Collection; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged Atrial Fibrillation - surgery Catheter Ablation - instrumentation Electrodes, Implanted Equipment Design Equipment Failure Analysis Female Fluoroscopy Follow-Up Studies Heart Atria - surgery Humans Israel Male Middle Aged Prospective Studies Pulmonary Veins - surgery Treatment Outcome |
| title | Safety, efficacy, and clinical applicability of pulmonary vein isolation with circular multi-electrode ablation systems: PVAC® vs. nMARQ™ for atrial fibrillation ablation |
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