Download Hospital of Cirie

Hospital of Cirie
Hospital of Rivoli
Mauriziano Hospital, Lanzo
Hospital of Chivasso
Medtronic Italy
Citation : Cardiostim 2002, Nice, France
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FIRST
EXPERIENCE
OF
PULMONARY
VEINS
CIRCUMFERENTIAL ISOLATION WITH LOCALISA
NAVIGATION SYSTEM AND COOLED-TIP ELECTRODE
Gaetano Senatore, Giovanni Carreras, Camillo Taglieri, Antonio
Mazza, Fabio Crescibene, Andrea Sibona Masi^, Benedetta
Giordano#, Marcella Jorfida*, Matteo Traverso,” Massimo Fazzari,
Hospital of Cirie1, ^Hospital of Rivoli, #Mauriziano Hospital, Lanzo,
*Hospital of Chivasso, “Medtronic Italia, Milan, Italy.
We report a new technique to reproduce circumferential ablation of
pulmonary veins (PV`s) with a new system (LocaLisa, Medtronic Inc.)
for real-time 3D localization of intracardiac electrodes. This method
uses an externally applied electrical field that is detected via standard
catheter electrodes. A special software shows the real time catheter
positions in 3D space. A 52-year-old woman with paroxysmal atrial
fibrillation refractory to antiarrhytmic drugs an without structural
heart
disease was reported for atrial fibrillation ablation with
circumferential isolation of PV`s. An irrigated tip ablation catheter
(Medtronic Inc. Sprinklr) was advance in the left atrium. We mapped
left superior and left inferior PV`s with a common ostium marked with
5 points, right superior and right inferior PV`s with 2 separate orifices
marked with 4 and 5 points respectively. Using the LocaLisa system,
we were then able to navigate the ablation catheter back to the PV`s
ostia an to monitor and guide catheter position during radiofrequency
(RF) application. We performed a single circumferential lesion around
the left PV`s and 2 separate lesions around right PV`s. To complete the
lesions, a total of 13 RF pulses were necessary for common ostium of
left PV`s; we completed right inferior and right superior encicirclings
with 11 and 9 RF pulses respectively. We considered the lesions as
completed when no potential was recorded inside the lesions and
pacing delivered inside the lesions with the ablation catheter was not
able to capture atria. Total procedure duration was 182 minutes, with
total procedural flouroscopy time of 22 minutes. The flouroscopy time
to complete the lesions was 7.5 minutes (2.3 and 2.1 minutes for right
superior and right inferior respectively; 3.2 minutes for left PV`s).
During a 5-month follow-up period, the patient remained symptomatic
without antiarrhytmie drug.