Abstract:Introduction
The critical question for technological advancement of catheter ablation of atrial fibrillation (AF) is whether a creative new concept can combine and even improve the options of single‐tip catheters with the simplicity of the use of balloon catheters. Herein are described the results from the first clinical study of a new multielectrode contact‐mapping plus ablation array (Globe) offering such a complete solution.
Methods and Results
The multielectrode Globe array consists of 16 flat ribs with 12… Show more
“…The designs are similar to currently studied or available commercial devices used for radiofrequency and PFA ablation. 2 , 3 , 4 Electrode dimension and spacing were chosen to be roughly similar to these devices, according to their published manuals or studies. Figure 1 The 3 catheter designs selected for comparison.…”
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
“…The designs are similar to currently studied or available commercial devices used for radiofrequency and PFA ablation. 2 , 3 , 4 Electrode dimension and spacing were chosen to be roughly similar to these devices, according to their published manuals or studies. Figure 1 The 3 catheter designs selected for comparison.…”
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
“…The temperature sensor is positioned 0.025 mm directly behind each electrode. 20,21 The catheter can be inserted into the left atrium through a specifically designed deflectable sheath (23 Fr in its old version, now reduced to 19 Fr).…”
Section: The Globe ® Catheter: Mapping and Ablation All In Onementioning
confidence: 99%
“…By combining these measurements with the known 3D shape of the array, the system calculates the position of the catheter with a high degree of accuracy. 20,21 The electrical information obtained from the 122 electrodes is also used to create many different types of electroanatomic maps, including local activation time mapping, voltage mapping and other standard A B maps. However, the system offers a few unique mapping solutions, as described below (Figure 3 and Figure 4).…”
Section: The Globe ® Catheter: Mapping and Ablation All In Onementioning
confidence: 99%
“…20 Kottkamp et al then published the first human experience, the Global AF study, in which the Globe catheter was used to perform PVI in 60 patients. 21 Initially, the system could ablate using a maximum of 16 electrodes at a time; however, in the last 34 patients treated, 24 electrodes were used simultaneously, allowing for single-shot ablation. The temperature set in the initial group was between 57°C and 61°C, but later it was increased to 65°C.…”
Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation ablation. Radiofrequency ablation has been the most common source of energy used to achieve PVI until now. In recent years, cryoballoon ablation has gained popularity due to its ability to perform PVI in a ‘single-shot’ fashion. In both cases (radiofrequency and cryoablation), the main limitation is their inability to achieve durable lesions without causing collateral damage to adjacent structures. In contrast, pulsed electric field (PEF) ablation is a non-thermal energy source that causes cell apoptosis by applying an electric current to the tissue. Lesions created by a field of energy seem to be more contiguous than traditional ablation, and the risk of damage to adjacent tissues is largely avoided due to the properties of the tissues and electrical fields. In recent years, new catheters capable of delivering PEF have been developed and are now undergoing clinical testing. In this article, we describe a complete solution for PVI: a single multielectrode catheter with 3D mapping capabilities that can deliver PEF in a single-shot PVI fashion with targeting beyond the pulmonary veins.
This article describes the advances in catheter ablation for AF that have allowed the creation of more durable and efficient lesions. It describes advances in high-power, short-duration radiofrequency ablation, radiofrequency balloon devices, ultra-low cryoablation and irreversible electroporation. It also considers the way these devices may change the way catheter ablation is performed for AF.
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