Validation of a novel spiral mapping catheter for real-time recordings from the pulmonary veins during cryoballoon ablation of atrial fibrillation

BACKGROUND The Achieve mapping catheter allows reg-time recordings from the pulmonary veins (PVs) during cryoballoon (CB) ablation of atrial fibrillation (AF). OBJECTIVE To assess the clinical applicability of the Achieve mapping catheter and the value of reg-time recordings from the PVs during CB. METHODS Patients with paroxysmal AF undergoing CB ablation were studied. Recordings from the PVs were analyzed during (real-time recordings) and after CB ablation and validated by using a variable circumferential mapping catheter (Achieve group; n = 20). A comparison was made by using a group of patients in whom CB ablation with a guidewire and a variable circumferential mapping catheter was performed (Guidewire group; n = 20). RESULTS Forty patients (age 58 +/- 11 years; ejection fraction 0.59 +/- 0.07; left atrial size 40 +/- 6 mm) with paroxysmal AF were included. In the Achieve group, reg-time recordings from the PVs could be obtained in 40 of 80 (50%) PVs and could be seen more often at the left-sided PVs (25 of 39, 64%) than at the right-sided PVs (15 of 41, 37%; P = .02). Validation with a standard circumferential mapping catheter confirmed PV isolation in 75 of 80 (93%) PVs. After a singe procedure and a follow-up of 14 +/- 4 months, 25 of 40 (63%) patients were in sinus rhythm with no significant difference between groups. CONCLUSIONS The Achieve catheter can be used as a substitute for a guidewire during CB ablation, but reg-time recordings can be obtained only in half of the PVs and are not sufficient to accurately confirm isolation of all PVs.