Pulmonary vein isolation (PVI) has become the mainstay of therapy for atrial fibrillation (AF) and one of the most frequently performed procedures in the cardiac electrophysiology laboratory. PVI by a single-tip radiofrequency (RF) ablation catheter remains a complex and time-consuming procedure, especially in centers with limited experience. In order to simplify the PVI procedure, to shorten it and reduce the complication rate, circular multi-electrode catheters were introduced for simultaneous mapping and ablation. The common concept of these ”single-shot” AF ablation technologies is the creation of circular lesions for PVI by placing the ablation device at the antrum of the pulmonary veins without the need for continuous repositioning. In this review we describe the main features of two circular non-balloon ablation catheters– PVAC®, which is based on the phased RF, duty-cycled ablation technology, and nMARQ™, the irrigated multi-electrode electro-anatomically guided catheter - and compare the clinical outcomes of these technologies, mainly for paroxysmal AF patients, based on current available data.
Credits: Avishag Laish-Farkash, MD, PhD, Mahmoud Suleiman, MD